Union Memorial Hospital Hip Arthroscopy Frank R. Ebert, M.D. Union Memorial Hospital Baltimore, Maryland
Hip Arthroscopy Burman JBJS 1931 First published report
Hip Arthroscopy Level of Acceptance began in 1980’s
Hip Arthroscopy Pre-Op Evaluation Mechanical Symptoms Catching / Locking Pain with hip flexion and internal rotation History of some torsional event about hip
Hip Arthroscopy Indications Avascular Necrosis Osteo Arthritis Septic Arthritis Labral Injuries Loose Bodies Foreign Body Retrieval Pediatric Disorders
Hip Arthroscopy
Hip Arthroscopy Indications
Hip Arthroscopy Indications
Hip Arthroscopy Pre-Op Evaluation Plain radiographs – AP pelvis / Lateral MRI – gadolinium enhancement plus marcaine
Hip Arthroscopy Operative Technique Fracture Table / Hip Distractor
Hip Arthroscopy Operative Technique Position Supine – Byrd-Arthroscopy 94 Lateral – Glick-Arthroscopy 87
Hip Arthroscopy Operative Technique Portals Lateral Antero Lateral Postero Lateral – not routinely used
Hip Arthroscopy Operative Technique Technique Supine Position Foot traction Well padded perineal post Lateral distraction - Key
Hip Arthroscopy Operative Technique
Hip Arthroscopy Operative Technique
Hip Arthroscopy Operative Technique Lateral Portal – 6” 18 gauge spinal needle under fluroscopic guidance
Hip Arthroscopy Operative Technique Seldinger Technique – cannulated obturator and sleeves passed over a wire
Hip Arthroscopy Operative Technique
Hip Arthroscopy Operative Technique Seldinger Technique – antero lateral portal Line drawn at intersection of ASIS and trochanteric line 45o cephalad and 30o toward the midline
Hip Arthroscopy Results Most common reason for arthroscopy Labral Tear – 70 to 80 percent success rate
Hip Arthroscopy
Hip Arthroscopy
Hip Arthroscopy
Hip Arthroscopy
Hip Arthroscopy
Hip Arthroscopy Complications Pudendal nerve neurapraxia Lateral femoral cutaneous neurapraxia Chondral scuffs from inadequate distration Sciatic neurapraxia – avoid postero lateral portal
Hip Arthroscopy
Hip Arthroscopy
Hip Arthroscopy
Hip Arthroscopy
Hip Arthroscopy Thank you