Revision Hip Arthroscopy

There are several reasons why a hip arthroscopy procedure may fail to alleviate a patient’s symptoms or lead to new complications, which may require revision hip arthroscopy or other types of intervention. Some common reasons for a failed hip arthroscopy include:

1. Incomplete correction of the underlying problem: The index hip arthroscopy procedure may not completely correct the underlying condition, such as a labral tear or femoroacetabular impingement, leading to continued pain or dysfunction.
2. Technical errors during the initial procedure: Technical errors during the hip arthroscopy procedure, such as incorrect placement of instruments or inadequate visualization of the hip joint, may result in incomplete or inadequate repair of the damaged tissue.
3. Development of new problems: The hip joint may develop new problems after the initial procedure, such as the development of scar tissue, instability, or arthritis.
4. Poor healing: The repaired tissue may sometimes not heal properly, leading to persistent pain or dysfunction.
5. Infection: Infection can occur after hip arthroscopy, leading to ongoing pain, inflammation, and joint damage.
6. Underlying conditions: Patients with underlying conditions such as hip dysplasia or osteoarthritis may not have complete symptom relief with hip arthroscopy and may require additional treatment such as joint replacement.

Revision hip arthroscopy may involve a similar or more extensive surgical approach than the initial procedure, depending on the problem’s specific nature. The goals of revision hip arthroscopy may include:

• repairing or removing scar tissue
• addressing residual bony abnormalities such as a cam or pincer hip impingement
• repairing a labral retear
• repairing a capsular defect
• removal of loose bodies
• *Circumferential labral reconstruction of an irreparable labral tear. *Note: this procedure is only completed by a handful of orthopedic surgeons worldwide.

During your consultation, discussing the causative factors for your prior failed hip arthroscopy is important. Understanding that some variables require intraoperative diagnostic visualization, our team will utilize published algorithms to determine your chance of success following revision hip surgery using currently available data, such as MRI results and X-ray findings. A small 4mm camera called an arthroscope is placed into the hip joint during revision hip arthroscopy with circumferential labral reconstruction. This allows the surgeon to visualize and assess the inside of the hip. In cases of irreparable labral injury, the injured/degenerative labral tissue is fully debrided along the entirety of the hip socket. Next, utilizing well-published techniques, new biologic tissue sized exactly to the patient’s anatomy is placed along the entire length of the prepared hip socket, hence circumferential labral reconstruction. This tissue is held in place by multiple modern low-profile suture anchors. All treatment options aim to recreate the stability and functionality of the hip, which ultimately restores hip biomechanics.