Revision Hip Arthroscopy

There are several reasons why a hip arthroscopy procedure may fail to alleviate a patient’s symptoms or may 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 have completely corrected 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: In some cases, the repaired tissue may not heal properly, leading to persistent pain or dysfunction.
5. Infection: Infection can occur after hip arthroscopy, and can lead 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 specific nature of the problem being addressed. The goals of revision hip arthroscopy may include:

• repairing or removing scar tissue
• addressing residual bony abnormalities such 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.

When presenting as a new patient to LALL Orthopedics ⁺, it is important to discuss in detail the causative factors for your prior failed hip arthroscopy. Understanding that some variables require intraoperative diagnostic visualization, using currently available date such as MRI results and Xray findings, our team will utilize published algorithms to determine your chance of success following revision hip surgery. During revision hip arthroscopy with circumferential labral reconstruction, a small 4mm camera called an arthroscope is placed into the hip joint. 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 the term circumferential labral reconstruction. This tissue is held in place by multiple modern low-profile suture anchors. All treatment options aim to recreate stability and functionality of the hip, which ultimately restores hip biomechanics.

It is important to note that revision hip arthroscopy is a complex and technically demanding procedure and should only be performed by experienced orthopedic surgeons who are skilled in this type of surgery. The hip surgeons at LALL Orthopedics ⁺ are widely regarded as national experts in circumferential labral reconstruction after having helped develop and publish on modern techniques used today. They regularly travel both nationally and internationally to speak at industry events and perform training seminars on the topic of revision hip arthroscopy. Our team is fortunate to help patients from New Jersey, Pennsylvania, Illinois and across the US who are suffering from a prior failed hip arthroscopy procedure.