Su, Charles A.

Background: Arthroscopic access to the hip can be challenging. We present a reproducible, safe, and efficient method for arthroscopic access to the hip. This can be especially beneficial for hips that may be predisposed to more difficult access. Indications: Hip arthroscopy is indicated in patients with symptomatic femoral acetabular impingement (FAI) who have failed conservative treatment options. FAI surgery aims to address both bony impingement and labral pathology in the hip. Technique: In this technique, we describe methodical steps to hip access. These steps include special attention to patient positioning and preoperative radiographs, air arthrogram, bevel control for needle joint entry, careful interpretation of intraoperative fluoroscopy, and adequate capsulotomy for viewing. Results: The majority of patients undergoing hip arthroscopy for FAI have improvements in both hip function and pain. Preoperative findings of increased center edge angle and male sex may predispose patients to more difficult hip arthroscopy access. The use of this technique may aid in reproducible access. Discussion/Conclusion: Hip arthroscopy is a good option for patients who have failed conservative treatment options and have signs and symptoms of FAI. Reproducible, safe, and efficient access to the hip is critical to starting hip arthroscopy cases. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Abstract Chronic conditions associated with aging have proven difficult to prevent or treat. Senescence is a cell fate defined by loss of proliferative capacity and the development of a pro‐inflammatory senescence‐associated secretory phenotype comprised of cytokines/chemokines, proteases, and other factors that promotes age‐related diseases. Specifically, an increase in senescent peripheral blood mononuclear cells (PBMCs), including T cells, is associated with conditions like frailty, rheumatoid arthritis, and bone loss. However, it is unknown if the percentage of senescent PBMCs associated with age‐associated orthopedic decline could be used for potential diagnostic or prognostic use in orthopedics. Here, we report senescent cell detection using the fluorescent compound C 12 FDG to quantify PBMCs senescence across a large cohort of healthy and osteoarthritic patients. There is an increase in the percent of circulating C 12 FDG + PBMCs that is commensurate with increases in age and senescence‐related serum biomarkers. Interestingly, C 12 FDG + PBMCs and T cells also were found to be elevated in patients with mild to moderate osteoarthritis, a progressive joint disease that is strongly associated with inflammation. The percent of C 12 FDG + PBMCs and age‐related serum biomarkers were decreased in a small subgroup of study participants taking the senolytic drug fisetin. These results demonstrate quantifiable measurements in a large group of participants that could create a composite score of healthy aging sensitive enough to detect changes following senolytic therapy and may predict age‐related orthopedic decline. Detection of peripheral senescence in PBMCs and subsets using C 12 FDG may be clinically useful for quantifying cellular senescence and determining how and if it plays a pathological role in osteoarthritic progression.