Bone defect classifications in revision total knee arthroplasty, their reliability and utility: a systematic review.

BACKGROUND: There are various classification systems described in the literature for managing bone defects in revision knee arthroplasty (RTKA). We analysed the reliability and usefulness of these classification systems. QUESTIONS/PURPOSES: (1) To review and critique the various classification systems proposed for bone loss in RTKA. (2) Among all the proposed classifications which one is the most commonly used by surgeons to report their results. (3) What is the reliability of various bone defect classification systems for RTKA. In this review, we have assessed the studies validating those classifications with a detailed description of the limitations and the proposed modifications. METHODS: This systematic review was conducted following PRISMA guidelines. Pubmed/Medline, CINAHL, EMBASE, Scopus, Cochrane databases and Web of Science databases were searched using multiple search terms and MeSH terms where possible. Studies meeting inclusion criteria were assessed for statistical parameters of reliability of a classification system. RESULTS: We found 16 classification systems for bone defects in RTKA. Six studies were found evaluating a classification system with reporting their reliability parameters. Fifty-four studies were found which classified bone loss using AORI classification in their series. AORI classification is most commonly reported for classifying bone defects. Type T2B and F2B are the most common bone defects in RTKA. The average kappa value for AORI classification for femoral bone loss was 0.38 (0.27-0.50) and 0.76 (0.63-1) for tibial bone loss assessment. CONCLUSION: None of the available classification systems is reliably established in determining the bone loss and treatment plans in RTKA. Among all, AORI classification is the most widely used system in clinical practice. The reliability of AORI Classification is fair for femoral bone loss and substantial for tibial bone loss.

Spontaneous subcapital femoral neck fracture complicating osteonecrosis of femoral head.

Spontaneous subcapital fracture (SSF) of femoral neck in pre-existent osteonecrosis of femoral head (ONFH) is a rare presentation. Only a few cases have been reported so far and majority of them have been reported to have unilateral hip involvement. We retrospectively reviewed clinical-radiological data of 10 patients (12 hips) with SSF complicating ONFH. All of them underwent uncemented total hip arthroplasty. All the available publications in the English language based medical literature were critically reviewed and results were summarized. The median age of presentation was 32 years (range : 24 years to 61 years). They were followed up for a mean duration of 25 months (range : 12 months to 59 months). The most common risk factor was corticosteroid consumption (7 out of 10 patients). All except one (modified Ficat and Arlet stage II) belonged to advanced stage of ONFH {stage III 3 patients (3 hips), stage IV 6 patients (8 hips)}. The mean time lag of ONFH to presentation was 22.3 months (range : 5 months to 60 months), and SSF to presentation was 13.8 days (range : 1 day to 28 days). Mean pre- operative Harris Hip Score was 10.8 (range : 8 to 14), which improved to 93 (range : 91 to 96) after total hip arthroplasty when last followed up (p<0.05). Corticosteroids induced ONFH has a propensity to develop SSF. This entity should find a place in existing classification system.

Virtual preoperative planning and 3D printing are valuable for the management of complex orthopaedic trauma.

PURPOSE: The technology of 3D printing (3DP) exists for quite some time, but it is still not utilized to its full potential in the field of orthopaedics and traumatology, such as underestimating its worth in virtual preoperative planning (VPP) and designing various models, templates, and jigs. It can be a significant tool in the reduction of surgical morbidity and better surgical outcome avoiding various associated complications. METHODS: An observational study was done including 91 cases of complex trauma presented in our institution requiring operative fixation. Virtual preoperative planning and 3DP were used in the management of these fractures. Surgeons managing these cases were given a set of questionnaire and responses were recorded and assessed as a quantitative data. RESULTS: In all the 91 cases, where VPP and 3DP were used, the surgeons were satisfied with the outcome which they got intraoperatively and postoperatively. Surgical time was reduced, with a better outcome. Three dimensional models of complex fracture were helpful in understanding the anatomy and sketching out the plans for optimum reduction and fixation. The average score of the questionnaire was 4.5, out of a maximum of 6, suggesting a positive role of 3DP in orthopaedics. CONCLUSION: 3DP is useful in complex trauma management by accurate reduction and placement of implants, reduction of surgical time and with a better outcome. Although there is an initial learning curve to understand and execute the VPP and 3DP, these become easier with practice and experience.

Evaluation of accuracy of virtual surgical planning for patient-specific pre-contoured plate in acetabular fracture fixation.

BACKGROUND: Acetabular fractures are amongst the most challenging fractures to treat because of complex anatomy. Open reduction and internal fixation remains the standard treatment for displaced acetabular fractures to achieve anatomical reduction as in any other intra-articular fracture. Patient-specific pre-contoured reconstruction plate template made by a pre-operative virtual surgical planning can be useful to respect patient's morphology, reduce surgical invasiveness and simplify the surgical procedure. Proper evaluation and surgical planning is necessary to achieve these goals. The goal of this study was to evaluate the outcomes of using virtual surgical planning and virtually pre-contoured plate template in comparison with the conventional method of intra-operative contouring of reconstruction plate for acetabular fracture fixation. METHODS: Twenty-five patients were categorized into group A and B by computerized randomization. In group A (12 patients), CT-based virtual surgical planning was done using Mimics and 3-Matic software to form virtually pre-contoured plates, which were 3D printed to act as templates over which 3.5 mm reconstruction plates were manually contoured pre-operatively and used for fixation. In group B (13 patient), conventional method of intra-operative contouring to adapt the plate to the fracture region was followed. Blood loss, surgical time, reduction on X-rays and post-operative computed tomography were compared between two groups. RESULTS: Duration of surgery and total blood loss were found to be less while reduction was found to satisfactory/anatomical in higher percentage of Group A than Group B patients. CONCLUSIONS: Virtual surgical planning, patient-specific virtually pre-contoured plate template and 3D printing technology improve the outcomes of acetabular fracture surgery by reducing duration and invasiveness of surgery and improving the quality of reduction. However, studies with larger sample size are required to further validate it.

Limb Salvage in Secondary Chondrosarcoma of the Metatarsus.

Malignant transformation of metatarsal osteochondroma into chondrosarcoma is a rare entity. The most optimal line of treatment, salvage procedure or amputation, continues to be debated. Both of these treatments have varied in popularity. We report the case of a 24-year-old male with chondrosarcoma secondary to differentiation of an osteochondroma in the second and third metatarsals. Wide resection of the tumor mass and reconstruction of the second and third metatarsals was performed using a simple and biologic approach. This was accomplished with an autologous nonvascularized fibular graft to reconstruct the longitudinal arch of the foot. The foot was successfully salvaged, with good anatomic, functional, and aesthetic results. At 1 year postoperatively, the patient was able to walk without any orthotic devices and had returned to his routine work. No evidence of local recurrence or metastasis was observed.

Subacute posttraumatic ascending myelopathy: A case report and review of literature.

Subacute posttraumatic ascending myelopathy is a rare disorder, unrelated to syrinx formation or mechanical instability, which may gradually emerge within the first 1-2 weeks after a spinal cord injury and may lead to diagnostic and prognostic dilemmas. We present a case of 24-year-old female with unstable wedge compression fracture of L1 vertebrae with signal changes in the upper lumbar cord causing complete paraplegia below D9 with bladder and bowel involvement. In the subsequent week, she developed a delayed progressively increasing neurological deficit with cord signal abnormality on MRI extending cephalad from the injury site to the upper dorsal cord. The patient had no initial clinical improvement initially but showed a delayed recovery over months.

Authorship in Scientific Manuscripts.

Authorship in scientific manuscripts indicates intellectual contribution of individuals to a research project and authors play a key role in the research and dissemination of results of a research project. It is important for authors to follow guidelines on authorship and submission of manuscripts and to agree on the order of authorship before beginning the project. Criteria for authorship, roles and responsibilities of authors, author metrics and misconduct of authors and their consequences are discussed in this editorial. Properly assigning authorship ensures transparency, accountability, and fairness in the scientific community.

Fatal Case of Giant Chondrosarcoma of Rib with Paraplegia: A Case Report.

Introduction: Chondrosarcoma of rib encroaching spine and subsequently leading to paraplegia has never been reported in the literature. Association of paraplegia can often lead to misdiagnosis with a common disease like breast cancer or Potts spine causing a significant delay in treatment. Case Report: We describe a case of a 45-year-old male with chondrosarcoma of rib with paraplegia who was misdiagnosed initially as Pott's spine and was started empirically on anti-tubercular treatment for paraplegia and chest wall mass. Further work up at tertiary care center including detailed imaging and biopsy revealed features of chondrosarcoma. However, before any definitive treatment could be done; the patient passed away. Conclusion: Empirical treatment of paraplegia with chest wall mass for more common diseases like tuberculosis are often initiated without obtaining appropriate radiological and tissue diagnosis. This can lead to a delay in diagnosis and initiation of treatment.

Ethics in Research and Publications.

Background: The purpose of this study is to present a comprehensive overview of the ethical issues and the processes involved in research and publishing in India. The study examines the present ethical norms, guidelines, frameworks and developments in India, providing insights into the nation's current status of research and recommendations for publication. This document will be a useful starting point and reference document for those embarking on research and publication in Orthopaedics in India. Materials: A survey of the literature was done, which included scholarly papers, reports, rules, and policies pertaining to Indian publishing norms and research ethics. the document starts with a general introduction to ethics, followed by the evolution of ethics in research and the current International as well as Indian codes of ethics. Subsequently, the discussion is divided into two broad headings of ethics in research and ethics in publishing. Under each heading, there are many specific areas in orthopaedics that would require the application of a unique set of ethics. These areas are discussed separately as subheadings. Results and Discussion: The review draws attention to the complexity of ethical issues in Indian and international research and publishing in orthopaedics. Where available, specific guidelines about the topic in India or international guidelines are discussed. The importance of informed consent, data integrity, plagiarism, authorship disputes, and conflicts of interest are only a few of the key results. It is obvious that ethical norms and regulations, such as those offered by the University Grants Commission (UGC), the Indian Council of Medical Research (ICMR), and the Council of Publication Ethics (COPE) are crucial in determining how research is conducted and how papers are published. The types of studies discussed include research in humans and animals, research with stem cells, metal implants and devices, orthobiologics, Artificial Intelligence, Robotics, computer modelling, virtual reality, 3D printing and bioprinting, tissue banking and data management. The roles of different personnel in research and publications are discussed. Conclusions: Ethics in research and publishing play a crucial role in establishing the authority and standard of scholarly work in India. This study underlines the key concepts of ethics that guide various types of studies and the publication process. It also highlights the requirement for frameworks and guidelines for certain unique areas of research in orthopaedics.

Is Masquelet Technique A Successful Viable Treatment In Reconstructing Large Tumor Bone Gaps in Adolescent and Adult?

Objectives: The reconstruction of large bony defect caused by tumor resection can be managed by different technique like bone graft, Masquelet technique, mega-prosthesis etc. Literature lacks studies discussing Masquelet technique in tumor cases especially pertaining to infected tumor in adults. We aimed to determine 1) How often and how fast is the bone healing achieved after resection greater than 10 cm bone in tumour patient's using Masquelet technique?, 2) Whether Masquelet technique can achieve optimum outcomes in adult infected cases too? Methods: We reviewed 154 patients of benign & malignant tumour managed by us between 2013 and 2019. Patients belonging to all the age group with infected tumor/diaphysial tumor/periarticular tumor, where single stage surgery or mega-prosthesis is not a viable option and were treated with Masquelet technique for reconstructing a bone defect of at least 10 cm were included in our study. We evaluated outcomes of eight patients for four parameters i.e. bony union, healing index, number of re-do surgeries required and limb length discrepancy. Results: Mean age of our study group was 20.25 years and patients followed for mean duration of 3.36 years. Mean bone loss after tumor resection was 13.1 cm (range = 11.5 cm to 15 cm). There was no sign of recurrence of tumor in any patient at the time of last follow up. Average time required to achieve bony union was 23.25 months (mean healing index of 1.67 months/cm). All but one patient achieved bony union. Mean limb length discrepancy seen was 1.44cm. Infected cases showed low healing index with higher percentage of re-do surgeries. Conclusion: Induced membrane technique is quick, safe and reliable alternative method of reconstruction to mega-prosthesis in cases with all age group where risk of failure of mega-prosthesis is high, either due to infection or shorter expected lifespan of prosthesis. However, obtaining union can be a difficult preposition in infected tumor cases and multiple surgeries may be required to get the desired result even after two stages. However, a comparative study with large sample size is required to further validate our results.

Accuracy of Patient-Specific, 3D-Printed Laminofacetal Based Trajectory-Guide for Pedicle Screw Placement in Subaxial Cervical and Thoracic Spine.

Background: Conventional methods of pedicle-screw placement have higher breach rates due to variations in pedicle trajectories. Objective: We studied the accuracy of patient-specific, three-dimensional (3D)-printed laminofacetal-based trajectory guide for pedicle-screw placement in the subaxial-cervical and thoracic spine. Materials and Methods: We enrolled 23 consecutive patients who underwent subaxial cervical and thoracic pedicle-screw instrumentation. They were divided into two groups: group A (cases without spinal deformity) and group B (cases with pre-existing spinal deformity). Patient-specific, 3D-printed laminofacetal-based trajectory guide for each instrumented level was designed. The accuracy of screw placement was assessed on postoperative computed tomography (CT) using the Gertzbein-Robbins grading. Results: A total of 194 pedicle screws (114 cervical and 80 thoracics) were placed using trajectory guides, of which 102 belonged to group B (34 cervical and 68 thoracics). Out of a total of 194 pedicle screws, 193 had clinically acceptable placement (grade A: 187; grade B: 6; and grade C: 1). In the cervical spine, 110 pedicle screws out of a total of 114 had grade A placement (grade B: 4). In the thoracic spine, 77 pedicle screws out of a total of 80 had grade A placement (grade B: 2; grade C: 1). Out of a total of 92 pedicle screws in group A, 90 had grade A placement, and the rest 2 had grade B breach. Similarly, 97 out of a total of 102 pedicle screws in group B were placed accurately, 4 had grade B and another had a grade C breach. Conclusions: Patient-specific, 3D-printed laminofacetal-based trajectory guide may help in accurate placement of subaxial cervical and thoracic pedicle screws. It may help reduce surgical time, blood loss, and radiation exposure.

Acquired Hallux Varus Deformity Correction: Pivotless Distraction Technique.

Acquired hallux varus deformity secondary to postburn contracture is a rare condition. It causes cosmetic disfigurement, pain, and inability to wear a shoe. Soft-tissue procedures and tendon transfers have been described for correction; however, these may require multiple operations and the outcome may be poor. We report a 6-year-old neglected case of hallux varus deformity secondary to burn contracture successfully managed by contracture release with pivotless distraction technique using a biplanar distractor and skin grafting with Z-plasty in the same procedure. The deformity was corrected to a lesser extent and with good functional outcomes. The scar was excised and Z-plasty was performed. The medial joint capsule was released. We used gradual differential distraction with monitoring on sequential radiographs. Pain-free flexion of 45° and extension of 40° were achieved and the patient was able to wear shoes after 4 weeks postoperatively. Hallux varus is a multidimensional deformity. A severe and rigid deformity might not respond well to tendon transfers in a single stage. Our described technique can be used to correct rigid hallux varus deformity with preservation of joint function.

Histopathological response to denosumab in giant cell tumours of bone - A review of 11 cases.

Background: Giant cell tumor (GCT) of the bone is a locally aggressive primary bone tumor, that can rarely metastasize. Arising mostly in epiphysis of the long bones in young adults, the tumor is composed of mononuclear cells that are admixed with osteoclastic giant cells(OLGCs), which express RANK ligand and RANK respectively. Denosumab a monoclonal antibody against RANK ligand has been shown to reduce the tumor by causing bone lysis by inhibiting RANKL. Histological changes in 11 patients of GCT who were treated with denosumab are presented here. Materials and Methods: Clinical records and slides of 11 patients of GCT who had been administered neoadjuvant denosumab were included in the study. Evaluation of pre and post therapy GCT specimens was performed by two pathologists (RK and VM). There were 4 males and 7 females. Their mean age was 30 years. All the patients received 120 mg denosumab subcutaneously every week with additional 120 mg on days 8 and 15 of therapy. The histological slides were reviewed and following points noted: 1) degree of ossification,2) fibrosis,3) loss of osteoclastic giant cells,4) proliferation of mononuclear cells,5) atypia,6) Permeation of osteoid by malignant cells. Results: Out of 11 cases, 2 cases did not show any significant histological improvement. 7 cases showed reduction in giant cells, increased fibrosis, enhanced mononuclear cell proliferation and ossification consistent with a pathological response. Atypia and osteoid permeation were noted in 2 cases which showed transformation to osteosarcoma. Conclusion: Denosumab treated giant cell tumor show dramatic histological changes. The post therapy lesions may bear no resemblance to pretherapy lesion. There may be complete resolution or may be confused with benign or malignant lesions Rarely they may show sarcomatous transformation. It is imperative that the pathologist is aware of these changes to prevent diagnostic pitfalls as it poses therapeutic and prognostic implications.

Bizarre parosteal osteochondromatous proliferation Nora's lesion: Case report of two cases with review of the literature.

ABSTRACT: Bizarre parosteal osteochondromatous proliferation (BPOP) is also known as Nora's disease. It is a benign lesion. Even though recent studies showed probable neoplastic etiology, the exact cause is unknown. BPOP commonly involves small bones of hands and feet. This condition is rare and very few cases are reported. In this report, two cases are presented with clinical, radiological, and histopathological findings. The first case was a 38-year-old female presented with 3-year history of mild painful swelling in the left middle finger and the second case was a 28-year-old male with the left leg swelling for 8 years. On radiology, both cases showed surface lesion with uninvolved medullary cavity. Excision specimen of both the lesions subjected for histopathological examination. Microscopically, there was irregular maturation of the bone and cartilage. Cartilage showed purplish-blue color (blue bone) with bizarre chondrocytes. BPOP is a rare benign condition. Awareness of clinical radiological and microscopic findings is needed for correct diagnosis and to differentiate it from other mimicking benign and malignant conditions.

Apex of Triceps Aponeurosis: A Reliable Landmark to Localize the Radial Nerve.

The posterior approach to the humerus is an extensile approach, which provides excellent access to the distal aspect of the humerus. The approach is traditionally utilized for internal fixation of fractures of the distal third of the humerus, to perform sequestrectomy, and for radial nerve exploration. The radial nerve is susceptible to damage when utilizing this approach1-3. Hence, accurate localization of the radial nerve is required to aid in identification during dissection and to minimize the risk of palsy. Various anatomical landmarks have been described in the literature that can help locate the radial nerve intraoperatively. Description: The patient is anesthetized and placed in the lateral decubitus position with the elbow of the operative limb hanging freely over a bolster. A posterior midline incision centered over the fracture is made on the posterior aspect of the arm. The superficial and deep fascia are incised. The triceps aponeurosis is formed by the convergence and fusion of the lateral and long heads of the triceps. The most proximal confluence can be termed the "apex of the triceps aponeurosis." The radial nerve can be isolated approximately 2.5 cm proximal to the apex by developing an intramuscular plane. The remainder of the intramuscular dissection for plate fixation can then be performed safely without risking injury to the radial nerve. Alternatives: Numerous studies have established the relationship of the radial nerve to a fixed osseous point such as the medial epicondyle, lateral epicondyle, and angle of the acromion4-9. Additionally, the wide range of measurements of these anatomic relationships, as reported in various studies, makes it difficult for the operating surgeon to locate the radial nerve, especially in the setting of a fractured humeral shaft. For example, the reported distance of the radial nerve from the lateral epicondyle ranges from 6 to 16 cm and the distance from the angle of the acromion ranges from 10 to 19 cm. Even identification of the superficial branch of the radial nerve has been shown to help intraoperative localization of the radial nerve10. However, these studies have been conducted on cadavers with intact humeri, and their accuracy has not been demonstrated on the patients in the clinical milieu of trauma. Rationale: The described soft-tissue landmark, which lies approximately 2.5 cm proximal to the apex of the triceps aponeurosis, reliably locates the radial nerve intraoperatively11. It is based on the anatomical fact that the origins of the lateral head (oblique ridge corresponding to the lateral lip of the spiral groove) and long head (infraglenoid tubercle of the scapula) are well above fractures of the middle and distal thirds of the humerus. Hence, the relationship of the radial nerve to the soft point represented by the apex of the aponeurosis is not likely to be disturbed in the setting of fractures distal to it, in sharp contrast with previously described osseous landmarks. Expected Outcomes: Employing this anatomical understanding resulted in early localization of the radial nerve (within 6 ± 1.5 minutes of skin incision) and less blood loss (188 ± 13 mL)11. Patients are likely to retain their ability to perform active dorsiflexion of the wrist and fingers and have sensory preservation in the distribution of autonomous zone of the radial nerve after the procedure. Important Tips: The relationship of the radial nerve to the soft point represented by the apex of the aponeurosis is not likely to be disturbed in the setting of typical fractures distal to it; however, this may differ in cases of severely displaced or comminuted fractures, and the surgeon should be aware of this fact.The surgeon should remain careful to protect the vena comitans.

Virtual planning on contralateral hemipelvis for posteriorly fixed acetabular fractures.

BACKGROUND: Open reduction and internal fixation is a standard treatment for displaced acetabular fractures using 3.5 mm reconstruction plates contoured intra-operatively. This process is difficult and time consuming hence resulting in increased surgical morbidity. Virtual surgical planning is now being commonly used worldwide to aid in management of such complex problems. Patient-specific reconstruction plate pre contoured using virtual surgical planning on contralateral intact hemipelvis will be helpful in achieving better surgical outcomes. Also, it has an added advantage of considerably reducing the time and effort spent in virtual pre-operative planning process. METHODOLOGY: This study was performed in 30 patients with acetabulum fracture who were fixed posteriorly via Kocher-Langenbeck approach. Virtual planning was done on contralateral hemipelvis to prepare patient-specific pre-contoured plates and mirrored to the fractured side. The time required for virtual planning on fractured and normal side was recorded and compared. The efficiency of plates so prepared were accessed in terms of outcome variables like duration of surgery, blood loss, reduction obtained on X-ray as well as CT Scan. RESULT: Time required for virtual planning was more on fractured side and lesser when it was done using normal hemipelvis with mean values of 81.83 (sd = 28.02) min and 15.67 (sd = 6.12) min, respectively. Values of blood loss, duration of surgery and reduction as accessed on X-ray and CT scan were comparable or even better than compared to other studies. CONCLUSION: Contralateral normal pelvis can be used for virtual preoperative planning making the whole process easier and less time consuming.

A method to localize the radial nerve using the 'apex of triceps aponeurosis' as a landmark.

BACKGROUND: The relationship of the radial nerve is described with various osseous landmarks, but such relationships may be disturbed in the setting of humerus shaft fractures. Alternative landmarks would be helpful to more consistently and reliably allow the surgeon to locate the radial nerve during the posterior approach to the arm. QUESTIONS/PURPOSES: We investigated the relationship of the radial nerve with the apex of triceps aponeurosis, and describe a technique to locate the nerve. MATERIALS AND METHODS: We performed dissections of 10 cadavers and gathered surgical details of 60 patients (30 patients and 30 control patients) during the posterior approach of the humerus. We measured the distance of the radial nerve from the apex of the triceps aponeurosis along the long axis of the humerus in cadaveric dissections and patients. This distance was correlated with the height and arm length. For all patients, we recorded time until first observation of the radial nerve, blood loss, and postoperative radial nerve function. RESULTS: The mean distance of the radial nerve from the apex of the triceps aponeurosis was 2.5 cm, which correlated with the patients' height and arm length. The mean time until the first observation of the radial nerve from beginning the skin incision was 6 minutes, as compared with 16 minutes in the control group. Mean blood loss was 188 mL and 237 mL, respectively. With the numbers available, we observed no difference in the incidence of patients with postoperative nerve palsy: none in the study group and three in the control group. CONCLUSION: The apex of the triceps aponeurosis appears to be a useful anatomic landmark for localization of the radial nerve during the posterior approach to the humerus.

Status of Hip Arthroscopy in India: A Short Questionnaire Based Survey and Review of Literature.

BACKGROUND: Hip arthroscopy is a minimally invasive technology for diagnostic and therapeutic interventions in various hip disorders. Over the past decade or so, the technology and understanding related to this surgery have improved by leaps and bounds; however, in India the overall pace has been limited. The present review highlights the status of hip arthroscopy in the Indian context. METHODOLOGY: A small survey with five questions related to practice of hip arthroscopy among Indian orthopaedic surgeons was conducted. Additionally a PubMed database search was conducted to recognise and assess studies pertaining to hip arthroscopy originating from India. RESULTS: Forty-two responses were received for the questionnaire, out of which 38 surgeons performed hip arthroscopy in their practice; the overall numbers were very low with only one respondent performing more than 50 surgeries in a year. For 84.2% of the respondents, the practice was limited to less than ten surgeries per year. 63.2% of the surgeons affirmed that there has been no change in their practice of hip arthroscopies over the past 5 years, signifying the slow growth and limited application of the technique. Only nine studies pertaining to the topic were available in the literature search, out of which five were case reports. The most common indication was removal of intraarticular foreign bodies, followed by joint debridement and lavage, synovial biopsies and femoroacetabular impingement (FAI). The outcomes in all the studies were satisfactory. CONCLUSION: Hip arthroscopy is in its nascent stages in India and much is still needed to be done for better implementation of the technique on a wider scale. Adequate training and continued medical education programme, with exposure to the experts in the field, will go a long way in better utilisation of the surgery in India.