Siva Chandrasekaran

Alfred Hospital · Department of Orthopaedics

Purpose: The purpose of this study was to conduct a matched-pair analysis to determine the effect of prior lumbar spine surgery (LSS) on clinical outcomes of hip arthroscopy. Methods: Data were prospectively collected on all patients undergoing hip arthroscopy during the study period from April 2008 to December 2012. Patients were excluded if th...

Purpose: To report clinical outcomes of arthroscopic labral reconstruction in the hip at minimum 2-year follow-up in comparison to a pair-matched labral repair group. Methods: Patients were included in this study if they underwent labral reconstruction during hip arthroscopy and had minimum 2-year follow-up data available. Exclusion criteria wer...

Technique for iliopsoas fractional lengthening. While on traction, the capsulotomy is extended medially and the medial and lateral borders of the iliopsoas bursa is debrided with a shaver to reveal the tendon. The tendon is divided with a beaver, leaving the muscular portion intact.

Pathology of the iliopsoas may cause painful internal snapping of the hip or labral damage from soft impingement. Favorable outcomes have been reported after arthroscopic release or fractional lengthening of the iliopsoas. In patients with risk factors for instability, restoration of other soft-tissue constraints such as the labrum and capsule shou...

Background: As hip arthroscopy has expanded in popularity and volume, more information is needed about indications for the procedure and the predictive factors of clinical outcomes. Purpose: To evaluate clinical outcomes of hip arthroscopy in a prospective study and to analyze the cohort to identify factors that are predictive of improvement. S...

The purpose of this study is to investigate whether robotic guidance in total hip arthroplasty (THA) can consistently correct native femoral version. One hundred seventy-five consecutive patients who underwent MAKO® (Stryker, Kalamazoo, Michigan) robotic-guidance THA were included in the study. The study population had a mean age of 57.9 years and...

Background Hip arthroscopic surgery is intended to treat multiple abnormalities in an effort to delay the progression to osteoarthritis, especially in young patients. However, the length of time in which patients experience joint pain before seeking a specialist for a diagnosis can delay hip preservation surgery and influence clinical outcomes. Pu...

Purpose: The primary purpose of this study was to report the prevalence of femoral head articular damage in patients with a central acetabular osteophyte (CAO) that was identified during hip arthroscopy and compare it with that in a matched control group without a CAO. A secondary purpose was to identify rates of coexisting intra-articular patholo...

Background Improvements in pain, function, and patient satisfaction are used to evaluate the outcomes of hip arthroscopic surgery. Purpose To identify correlations between the visual analog scale (VAS) score for pain and patient satisfaction with 4 commonly used patient-reported outcome (PRO) scores to determine to what extent changes in these 2 p...

Background: Advancements in instrumentation and techniques have extended the scope of hip arthroscopic surgery to treat complex osseous deformities that were previously best addressed with an open approach. Global pincer-type femoroacetabular impingement is an example of an abnormality requiring osseous correction with a technically challenging ac...

Background: Hip pain remains a challenge given the multiple factors that can cause damage to the articular cartilage, such as traumatic injury, metabolic damage, and morphologic variations such as femoroacetabular impingement (FAI) and that can contribute to progression of osteoarthritis. However, a direct relationship between patient characterist...

Purpose: This study aims to present 3 patients' results after undergoing gluteus maximus and tensor fascia lata (TFL) transfer for chronic abductor tears unable to be repaired primarily. Methods: 3 patients were identified intraoperatively as having an abductor tear unable to be repaired primarily. The anterior 1/3 of the gluteus maximus and the...

This article describes the arthroscopic approach and management of a “reverse contre-coup” injury to the hip labrum. The injury occurs in the setting of posterolateral acetabular rim over-coverage impinging on the distal femoral neck in extension causing the femoral head to lever out anteriorly against the labrum. Ligamentous laxity and associated...

Purpose To report mean 2-year patient-reported outcomes (PROs) and the incidence of revision hip arthroscopy or conversion to total hip arthroplasty (THA) in patients who had undergone arthroscopic reconstruction of the hip labrum for segmental defects. Methods Data were prospectively collected and retrospectively reviewed on all patients who had...

Purpose: To report on patterns of clinical presentation, intra-articular derangements, radiological associations, and minimum 2-year outcomes after hip arthroscopy (HA) in patients 18 years or younger. Methods: This study was a retrospective case series on patients 18 years or younger who had undergone HA for labral tears that had failed nonoper...

Purpose: To report minimum 2-year patient-reported outcomes (PROs) after hip arthroscopy (HA) for symptomatic labral tears in patients with global acetabular overcoverage. Methods: This study was a retrospective case series of patients who underwent HA from April 2008 to April 2013. The inclusion criteria were patients with global acetabular ove...

Purpose: To report clinical outcomes in patients with borderline dysplasia undergoing an arthroscopic technique of labral seal restoration with minimal acetabular rim resection and capsular plication. Methods: Patients younger than 40 years with a lateral center-edge angle of 18° greater and 25° or less and 2-year follow-up after undergoing an a...

Purpose: To compare the acetabular component size relative to the patient's native femoral head size between conventional THA (CTHA) approach and robotic-arm assisted THA (RTHA) to infer which of these techniques preserved more acetabular bone. Methods: Patients were included if they had primary osteoarthritis (OA) and underwent total hip replac...

To perform a proper labral repair, most surgeons use anchors to secure the labrum to the acetabular bone. We aim to describe a technique for labral repair with a knotless tensionable suture anchor. This technique uses a looped suture configuration, allowing selective tensioning of the repair to maintain the anatomic suction seal of the hip. The use...

Purpose: To assess 2-year clinical outcomes of patients who underwent hip arthroscopy for central acetabular osteophytes (CAO) treated with central acetabular decompression (CAD), and to compare these outcomes with those of a matched control group. Methods: Data were prospectively gathered for patients undergoing CAD during hip arthroscopy from...

This study presents the results of four Ligamentum Teres (LT) reconstruction procedures for hip instability with an average of 21.4 months follow-up (range 16.4–27.8). The indication for reconstruction was patients who complained of hip instability (hip giving way on gait or activities of daily living) on a background of a connective tissue disorde...

Background: Osteoarthritis adversely impacts hip arthroscopy outcomes. The purpose of this study was to conduct a matched-pair analysis with a mean follow-up of 2 years to evaluate the outcomes following hip arthroscopy in patients with Tönnis grade-2 osteoarthritis. Methods: Data were prospectively collected on all patients undergoing hip arthr...

Background: Hip arthroscopic surgery has emerged as a successful procedure to manage acetabular labral tears and concurrent hip injuries, which if left untreated, may contribute to hip osteoarthritis (OA). Therefore, it is essential to analyze the economic impact of this treatment option. Purpose: To investigate the cost-effectiveness of hip art...

Background: There are limited studies on the effect of mild osteoarthritis (OA) on outcomes of hip arthroscopic surgery. Purpose: To conduct a matched-pair analysis with a minimum 2-year follow-up to evaluate outcomes after hip arthroscopic surgery in patients with Tönnis grade 1 OA. Study design: Cohort study; Level of evidence, 3. Methods:...

There is a paucity of literature regarding microfracture surgery in the hip. The purpose of this study was to compare outcomes in patients undergoing hip arthroscopy predominantly for labral tears with focal full thickness chondral damage on the acetabulum or femoral head treated with microfracture and a matched control group that did not have foca...

Purpose: To compare patient-reported outcome (PRO) and rates of conversion to total hip arthroplasty (THA) after hip arthroscopy, Bernese periacetabular osteotomy (PAO), and a combined approach for the management of patients with different grades of hip dysplasia. Methods: We searched MEDLINE and PubMed databases for articles published since 2000 u...

Background: Surgical intervention for partial and full-thickness gluteus medius tears is often recommended for patients who have persistent pain despite nonoperative treatment. Traditionally, the surgical intervention has been carried out through open techniques with good results; however, advantages of endoscopic techniques include less tissue di...

Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) has been used in the detection of chondropathy. Our study aimed to determine whether dGEMRIC indices are predictive of two-year patient-reported outcomes and pain scores following hip arthroscopy. Between August 2008 and April 2012, sixty-five patients (seventy-four hips)...

This study aims to validate a modified circle theorem method for the calculation of true version of the acetabular component on anteroposterior x-rays with intra-operative version data derived from robotic assisted total hip arthroplasty (THA). Planar anteversion measurements recorded intraoperatively in 80 THAs were correlated to measurements on a...

Objectives The purpose of this study was to evaluate clinical outcomes, pain, and patient satisfaction following all hip arthroscopies performed by a single surgeon at a high volume referral center with a mean 2-year follow-up. Methods During the study period, February 2008 to June 2012, data were collected on all patients undergoing hip arthrosco...

Microfracture is a marrow-stimulation technique in which damaged cartilage is drilled or punched, perforating the subchondral bone and generating a blood clot within the defect that matures into fibrocartilage. Microfracture for the treatment of small cartilage defects of the hip has shown good results. Arthroscopic procedures are less invasive tha...

Microfracture in hip preservation surgery has demonstrated favorable outcomes, but studies with a higher level of evidence assessing microfracture are warranted. To assess 2-year outcomes of patients who underwent hip arthroscopy with full-thickness chondral damage treated with microfracture and compare these outcomes with those of a control group...

To compare the outcome of open versus endoscopic gluteal tendon repair. An extensive review of PubMed was conducted by 2 independent reviewers for articles containing at least 1 of the following search terms: gluteus medius, gluteus medius tear, gluteus medius tendinopathy, gluteus medius repair, hip abductors, hip abductor tears, hip abductor repa...

Atraumatic instability or microinstability of the hip is a recognized cause of groin pain and hip instability. Risk factors include female sex, ligamentous laxity, and borderline dysplasia. Arthroscopically, the joint may distract easily, and there may be associated ligamentum teres tears and laxity of the capsule on manual probing. The use of arth...

The primary purpose of this review article is to discuss the role of diagnostic, corticosteroid, hyaluronic acid (HA) and platelet rich plasma (PRP) in the treatment of osteoarthritis (OA) and femoroacetabular impingement (FIA). These treatments play an important biological role in the non-operative management of these conditions. Two independent r...

Background: Gluteus medius tears are a common cause of lateral hip pain. Operative intervention is usually prescribed for patients with pain despite physical therapy and/or peritrochanteric injections. Purpose: To identify clinical features that predict operative intervention in gluteus medius tears. Study design: Case control study; Level of...

Background: Hip dysplasia has been shown to be a cause of early arthritis. The decrease in bony coverage has shown increased stress on the acetabular labrum as it shares an increased load. Purpose/hypothesis: The purpose of this study was to divide a cohort of patients by radiographic measures of dysplastic and nondysplastic hips for comparison...

An understanding of the kinematics of posterior cruciate ligament (PCL) deficiency is important for the diagnosis and management of patients with isolated PCL injury. The kinematics of PCL injury has been analysed through cadaveric and in vivo imaging studies. Cadaveric studies have detailed the anatomy of the PCL. It consists of two functional bun...

The aim of the present study was to compare the in vivo articulation of the healthy knee to the contralateral knee of subjects with acute and chronic PCL injuries. Magnetic resonance was used to generate sagittal images of 10 healthy knees and 10 knees with isolated PCL injuries (5 acute and 5 chronic). The subjects performed a supine leg press aga...

Cadaveric studies have shown that the posterior cruciate ligament (PCL) is an important constraint to posterior translation of the tibia. Arthroscopic studies have shown that chronic PCL injuries predispose to articular cartilage lesions in the medial compartment and the patellofemoral joint. The aim of the present study was to investigate sagittal...

Both chemical and mechanical methods of prophylaxis have reduced the incidence of thromboembolic complications following total knee replacement (TKR). Only a few studies have shown that mobilization on the first post‐operative day further reduces the incidence of thromboembolic phenomena. We conducted a prospective study to verify not only if early...

The combination of imageless computer-aided surgery (CAS) and minimally invasive surgery (MIS) for total knee arthroplasty (TKA) has not been reported. This study presents the initial 30 procedures in which imageless CAS was combined with MIS for TKA by the senior author. Coronal alignment of femoral and tibial components with respect to the mechan...