Paul Kenneth Herickhoff, M.D., Jason Eric Mascoe, B.S.

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Presentation transcript:

Fluoroscopy-Guided Suture Anchor Placement for Acetabular Labrum Repair Paul Kenneth Herickhoff, M.D., Jason Eric Mascoe, B.S. Arthroscopy Techniques Volume 8, Issue 5, Pages e437-e442 (May 2019) DOI: 10.1016/j.eats.2018.12.001 Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 1 Right hip arthroscopic view from the anterolateral portal. The acetabular labrum is torn through the chondrolabral junction from the 12 o'clock to the 2 o'clock position. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 2 Right hip arthroscopic view from the midanterior portal. A straight drill guide enters the hip through the distal anterolateral accessory portal. The tip of the drill guide is located at the 12 o'clock position, 2.3 to 2.6 mm from the acetabular rim. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 3 Anteroposterior fluoroscopic view of the right hip shows a straight drill guide, inserted from a distal anterolateral accessory portal and positioned at the 12 o'clock position on the acetabular rim, slightly divergent from the subchondral bone. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 4 Anteroposterior fluoroscopic view of the right hip shows a 1.4-mm diameter, 17 mm long drill bit inserted through a distal anterolateral accessory portal into the acetabular rim at the 12 o'clock position, slightly divergent from the subchondral bone. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 5 This pictorial representation of the acetabulum depicts x-ray beams tangential to the acetabular rim at the 11 o'clock to 3 o'clock positions, enabling the surgeon to fluoroscopically visualize the subchondral bone at these locations. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 6 Right hip arthroscopy room setup. The C-arm is rotated backward 30° to view the subchondral bone at the 1 o'clock position on the acetabulum. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 7 Right hip arthroscopic view from the anterolateral portal. A straight drill guide enters the hip through the distal anterolateral accessory (DALA) portal. The tip of the drill guide is located at the 1 o'clock position, 2.3 to 2.6 mm from the acetabular rim. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 8 Fluoroscopic view of the right hip with the C-arm rotated 30° backward, showing the drill bit slightly divergent from the subchondral bone at the 1 o'clock position on the acetabulum. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 9 Right hip arthroscopy room setup. The C-arm is rotated backward 60° to view the subchondral bone at the 2 o'clock position on the acetabulum. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 10 Fluoroscopic view of the right hip with the C-arm rotated 60° backward, showing the straight drill guide parallel to the subchondral bone at the 2 o'clock position on the acetabulum. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 11 Fluoroscopic view of the right hip with the C-arm rotated 60° backward, showing the 1.4-mm diameter, 17 mm long drill bit parallel to the subchondral bone at the 2 o'clock position on the acetabulum. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 12 Right hip arthroscopic view from the anterolateral portal. Inspection of the acetabular labrum repair with traction released shows excellent restoration of the suction seal between the labrum and femoral head. Arthroscopy Techniques 2019 8, e437-e442DOI: (10.1016/j.eats.2018.12.001) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions