Textbook chapter: loose bodies tips and pearls


Intra-articular loose bodies are known as a cause of pain. Hip arthroscopy is an ideal setting for the removal of loose bodies; it is minimal invasive and with high potency for removal of loose bodies. However, not all loose bodies have to be removed; moreover, not all can be treated successfully arthroscopically.

Free bodies in the hip joint can be loose or attached and can be due to a variety of different etiologies: posttraumatic fractures of the femoral head or acetabulum, synovial chondromatosis, degenerative joint disease, osteochondritis dissecans after Legg-Calve-Perthes disease, unfused secondary ossification center of the acetabulum (a.k.a. os acetabuli) calcium deposit within the labrum, and ossification of the labrum. This chapter details the properties of each source-free body in the hip joint, presents a case, and discusses the treatment.

The authors’ experience is also shared with the reader. Loose bodies were found in 12% of the cases among 728 in hip arthroscopies. The group of patients with loose bodies had higher average age, higher Tonnis arthritic grading, and larger labral tears. Moreover, pain was higher according to the visual analog scale before the surgery, however similar after.

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