Good questions, if you have any. I just wanted to start with Blake. Very well done study. My question for you, two questions. One, we used to use fascia iliacus blocks, and we had a number of patients that fell down post-operatively, and some concerns over muscle recovery after blocks in athletes. Any issues with that? And my second question would be, since you didn't do an intraarticular anesthetic injection, any thought in a more relevant control group would be comparing the fascia iliacus block to actual intraarticular anesthetic injection versus nothing at all? I think that's, well, firstly, as far as the falls are concerned, there were zero falls in either group. So we were lucky in that regard. Our anesthesiologists were very experienced with this particular block. I think if you infiltrate too much around the femoral nerve, you can certainly decrease quad strength, and falls can happen. And then in terms of the control group, that's an excellent study idea. We just have to do one study at a time. Actually, I don't want to misquote. I think Alan Zhang from California, UCSF, did that study, intraarticular with local anesthetic around the portal sites versus fascia iliacus block. No difference in pain, higher falls in fascia iliacus block. I think it was published last year. Dean? A couple of questions. One, on the capsulotomy trends or study, did I hear you right or see it right that in the 18 or 19 dislocation cases that 2 thirds were repaired? Correct. 1 third was not repaired. You have any comment with that? With the small study, it's hard to say. I think the big takeaway from what we saw with the dislocations is that so many of them were not published. So I think with even some previous studies, comparing the two types, either repairing the capsule or not repairing the capsule and the outcomes with it, it's hard to say if some of these are going underreported. Good point. And on the angle of approach and the intraarticular or blowout posteriorly or anteriorly anchors, we published a small case report, five studies in the Ricky Villars journal. But I just threw out two pearls. And I don't know if you guys accounted for this, is if you put the drill parallel to the floor on a standardized supine pelvis, you're not going to enter the hip joint. And the other thing I learned from experience, having entered the hip joint and having had posterior blowout, is when we go back below 10 o'clock posteriorly, so even to 9, using a curved guide facing anteriorly can prevent the dreaded posterior blowout of an anchor. I think those are great comments and pearls. In terms of the curved posteriorly, we noticed that, as well as we were kind of working with it, we thought, well, this would really work better if we turned it in. But we wanted to keep the study the same. So we always had basically the curve pointed orthogonal and outwards of the acetabulum. But of course, those had a high rate of blowing out. But yeah, good information. Thank you. This question is for Dr. Westerman. Psychiatric disorders and osteoarthritis, grouping those two things together is kind of like grouping the worst known outcome in osteoarthritis with the most commonly reported coexistent condition in all prior published sets, meaning we've seen numerous reports, including one from our MASH study group, about how 60% of our patients have anxiety or depression with good outcomes in hip arthroscopy. So is there a way for you to separate out the psychiatric component from the osteoarthritis component in your findings? Does this make sense to you? Well, they're both independently associated. So we did use logistic regression. And independently, they both would predict failure or revision surgery in a hip scope setting. In your group and in other groups, there have been success, but with not as good outcomes. So I guess I'm trying to understand how you found them to be a failure predictor. Yeah, no, that's a good point. I think several papers have shown that the delta can be similar in patients with anxiety and depression. They start out lower, they'll end lower. So depending on if you're measuring by MCID, then you can say this is a successful procedure. If you're, depending on how you qualify your outcomes, if you say you need to be a 75 or higher on modified Harris hip, you might not qualify depending on where you start. I do agree that they start lower, they end lower. And patients with psychiatric comorbidities, it's probably how they interact with the outcome score and how they just answer questions based on, you know, whatever is going on. I think there's a big, you know, area for improvement there as well. Just to add in on that, I think one of, in terms of how people answer questions and how they interpret what they're feeling, we started collecting the pain catastrophizing scale. I think it's a really useful scale and adds a lot of information because two people with the same hip can really interpret their symptoms very differently. But I think that that's, that study's really important. One last question, Dr. Krautler, with your study, I'd be interested to see like a crossover arm where the group, the people that failed in the HA group then cross over to the PRP group to see if, in fact, they then improve and do better. And I'm curious if you thought about something like that or if you have, if you or your authors have any experience with that. That's a great point. We didn't specifically look at that. Omar, do you have any comments on patients just from your experience who have crossed over? I'm up to three years only. We didn't know anything before that. Okay. Thanks, guys. We'll go ahead and go into the next session. Great job. Thank you.

iliacus block

capsulotomy repair

hip joint surgery

psychiatric disorders

crossover treatment