title: Best Practices During Hip Arthroscopy: Aggregate Recommendations of High-Volume Surgeons.
abstract: OBJECTIVE
  To survey surgeons who perform a high volume of hip arthroscopy procedures regarding their operative technique, type of procedure, and postoperative management.
  
  
  METHODS
  We conducted a cross-sectional survey of 27 high-volume orthopaedic surgeons specializing in hip arthroscopy to report their preferences and practices related to their operative practice and postoperative rehabilitation protocol. All participants completed the survey in person in an anonymous fashion during a meeting of the American Hip Institute.
  
  
  RESULTS
  All surgeons perform hip arthroscopy with the patient in the supine position, accessing the central compartment of the hip initially, using intraoperative fluoroscopy. All surgeons perform labral repair (100%), with the majority performing labral reconstructions (77.8%) and gluteus medius repairs (81.5%). There is variability in the type of anchors used during labral repair. Most surgeons perform capsular closure in most cases (88.9%), inject either intra-articular cortisone or platelet-rich plasma at the conclusion of the procedure (59%), and prescribe a postoperative hip brace for some or all patients (59%). There is considerable variability in rehabilitation protocols. All surgeons routinely prescribe postoperative heterotopic ossification prophylaxis to their patients, with most surgeons (88.9%) prescribing a nonsteroidal anti-inflammatory medication for 3 weeks. Forty percent of the respondents use the modified Harris Hip Score as the most important outcome measure.
  
  
  CONCLUSIONS
  Consistent practices such as use of intraoperative fluoroscopy, heterotopic ossification prophylaxis, and labral repair skills were identified by surveying 27 hip arthroscopy surgeons at high-volume centers. Most of the surgeons performed routine capsular closure unless underlying conditions precluded capsular release or plication. The survey identified higher variability between surgeons regarding postoperative rehabilitation protocols and use of intra-articular pharmacologic injections at the end of the procedure. These data may provide surgeons with a set of aggregate trends that may help guide training, clinical practice, and research in the evolving field of hip arthroscopy.
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Asheesh
authors.initials: A
authors.lastname: Gupta
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Carlos
authors.initials: C
authors.lastname: Suarez-Ahedo
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: John M
authors.initials: JM
authors.lastname: Redmond
authors.affiliation: Santa Monica Orthopaedic and Sports Medicine Group, Santa Monica, California, U.S.A.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Gerhardt
authors.affiliation: Arthrex, Naples, Florida, U.S.A.
authors.forename: Bryan
authors.initials: B
authors.lastname: Hanypsiak
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Stake
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Finch
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.; Hinsdale Orthopaedics, Westmont, Illinois, U.S.A.; Loyola University Chicago Stritch School of Medicine, Chicago, Illinois, U.S.A.. Electronic address: DrDomb@americanhipinstitute.org.
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Domb
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data*; D019985:Benchmarking; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic