Lumbosacral transitional vertebrae (LSTV) are increasingly recognized as a common anatomical variant and is the most common congenital anomaly of the lumbosacral spine. Patients can have symptomatic LSTV, known as Bertolotti's Syndrome, where transitional anatomy can cause back, L5 distribution leg, hip, and groin pain. We propose an outline for diagnosis and treatment of Bertolotti's Syndrome. We retrospectively reviewed over 500 patients presenting to the primary author with low back, buttock, hip, groin and/or leg pain from April 2009 through April 2024. Patients with radiographic findings of an LSTV and clinical presentation underwent diagnostic injections to confirm diagnosis of Bertolotti's syndrome. Treatment was determined based on patient's LSTV classification. 157 patients with confirmed Bertolotti's syndrome underwent surgical treatment.Introduction
Methods
With the evolution of hip arthroscopy, it has been used as joint preserving surgery for osteoarthritis among various other indications. The purpose of this study was to assess the factors that affect the subgroup of patients with osteoarthritis that have had total hip replacements following hip arthroscopy. Data was retrieved retrospectively from 556 osteoarthritic patients' files that have had hip arthroscopy between the years 2002 to 2009 (mean follow up time 3.2 – range 1 to 6.4 years). Eighty-three (15%) of them have had eventually total hip replacement. The data analysis included different variables (i.e. age, arthritic stage, repeated procedures) that may have influenced the time elapsed between the hip arthroscopy and consecutive replacement procedures.Introduction
Methods
Hip arthroscopy is becoming more popular. A literature review demonstrated paucity of published papers reporting the outcome of hip arthroscopy in teenagers without developmental dysplasia of the hip. Our aim was to record the type of lesions found and report the outcome and level of satisfaction following hip arthroscopy in teenagers. From 2002 to 2008, 96 hip arthroscopies were undertaken in 76 patients. Pre-operative and two-week, six-week and current post-operative assessments were performed using the modified Harris hip score (HHS) and the Non Arthritic Hip Score (NAHS). In addition, a satisfaction survey was completed at their most recent review. Patients enrolled in the study were under the age of 20. Patients with a history of developmental dysplasia of the hip, Perthes disease and arthritis were excluded from the study. Patients had at least a six-month follow-up from their surgery. Our study cohort comprised 53 males and 43 females with an average age of 17 years old (range 13 to 19 years). The average duration of follow up was 19 months (range 3 to 75 months). There were 41 left and 54 right-sided hip arthroscopies. There were five re-operations. The average duration of hip traction was 19 minutes (range 6 to 47 minutes). We found pathology in all hips that underwent arthroscopy. We report a significant improvement in MHHS and NAHS at six weeks and current review (p-value <0.01). Sixty-two percent of patients had returned to sport at the previous level of competition, 32% of patients returned to sport at a lower level of competition and 5% patients did not return to sport. Overall, 84% of patients were satisfied following their hip arthroscopy and 91% would have the surgery again if they had to. There were five re-operations. Our study has revealed a range of intra articular hip pathologies amenable to surgical treatment using hip arthroscopy. We have observed a significant improvement in hip scores; with up to 94% of patients returning to sport in the short term with high satisfaction levels. Long term follow up of this group is ongoing.
