Over half of postpartum women experience pelvic ring or hip pain, with multiple anatomic locations involved. The sacroiliac joints, pubic symphysis, lumbar spine and pelvic girdle are all well documented pain generators. However, despite the prevalence of postpartum hip pain, there is a paucity of literature regarding underlying soft tissue intra-articular etiologies. The purpose of this systematic review is to document and assess the available evidence regarding underlying intra-articular soft tissue etiologies of peri- and postpartum hip pain. Three online databases (Embase, PubMed and Ovid [MEDLINE]) were searched from database inception until April 11, 2021. The inclusion criteria were English language studies, human studies, and those regarding symptomatic labral pathology in the peri- or postpartum period. Exclusion criteria were animal studies, commentaries, book chapters, review articles and technical studies. All titles, relevant abstracts and full-text articles were screened by two reviewers independently. Descriptive characteristics including the study design, sample size, sex ratio, mean age, clinical and radiographic findings, pathology, subsequent management and outcomes were documented. The methodological quality of the included studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) instrument. The initial search identified 2472 studies. A systemic screening and assessment of eligibility identified 5 articles that satisfied the inclusion criteria. Twenty-two females were included. Twenty patients presented with labral pathology that necessitated hip arthroscopy with labral debridement or repair with or without acetabuloplasty and/or femoroplasty. One patient presented with an incidental labral tear in the context of osteitis condensans illi. One patient presented with post-traumatic osteoarthritis necessitating a hip replacement. The mean MINORS score of these 5 non-comparative studies was 2.8 (range 0-7) demonstrating a very low quality of evidence. The contribution of intra-articular soft tissue injury is a documented, albeit sparse, etiology contributing to peri- and postpartum hip pain. Further research to better delineate the prevalence, mechanism of injury, natural history and management options for women suffering from these pathologies at an already challenging time is necessary to advance the care of these patients

Introduction. Acetabular osteotomy is considered to be an alternative treatment for acetabular dysplasia, particularly in adolescents and young adults because the long-term results of total hip arthroplasty (THA) in such patients remain controversial. To our knowledge, few reports have described the relationship between the types of osteotomies and surgical difficulty. We compared the operative and clinical results of THA following the 3 main types of acetabular osteotomies, including Chiari osteotomy, rotational periacetabular osteotomy (RAO), and shelf acetabuloplasty. Methods. Operative records of 13 hips following Chiari osteotomy (Chiari group), 22 hips following RAO (RAO group), and 16 hips following shelf acetabuloplasty (Shelf group) were retrospectively reviewed. Operative records of 2475 primary THAs without previous osteotomies during the same period were reviewed as a control. The direct anterior approach was used for all hips. Results. The mean operative time was 57.7 ± 11.7 min in the Chiari group, 68.7 ± 25.7 min in the RAO group, 57.4 ± 20.5 min in the shelf group, and 50.6 ± 18.5 min in the Control group. The operative time was significantly longer in the RAO group than in the Control group (p < 0.05). The mean operative blood loss was 406 ± 277 g in the Chiari group, 439 ± 400 g in the RAO group, 377 ± 163 g in the Shelf group, and 379 ± 270 g in the Control group. Allogeneic blood transfusion was performed in 1 patient (4%) in the RAO group and in 26 patients (1%) in the Control group. Bulk bone augmentation to the acetabular defect was performed in 2 hips (15%) in the Chiari group, 7 hips (32%) in the RAO group, and 87 hips (3.5%) in the Control group. The requirement for bulk bone augmentation to the acetabular defect was significantly higher in the Chiari and RAO groups than in the Control group (p < 0.05). Aseptic loosening occurred in 2 cups in the RAO group and postoperative dislocation occurred in 1 hip in the Chiari group. Conclusion. RAO made the conversion to THA complicated because of acetabular defects. Chiari osteotomy was less effective and shelf acetabuloplasty had no effect on surgical results of conversion THA