1. Union Memorial Hospital
Hip Arthroscopy
Frank R. Ebert, M.D.
Union Memorial Hospital
Baltimore, Maryland

2. Hip Arthroscopy
Burman JBJS 1931
First published report

3. Hip Arthroscopy
Level of Acceptance began in ’s

4. Hip Arthroscopy Pre-Op Evaluation
Mechanical Symptoms
Catching / Locking
Pain with hip flexion and internal rotation
History of some torsional event about hip

5. Hip Arthroscopy Indications
Avascular Necrosis
Osteo Arthritis
Septic Arthritis
Labral Injuries
Loose Bodies
Foreign Body Retrieval
Pediatric Disorders

6. Hip Arthroscopy

7. Hip Arthroscopy Indications

8. Hip Arthroscopy Indications

9. Hip Arthroscopy Pre-Op Evaluation
Plain radiographs – AP pelvis / Lateral
MRI – gadolinium enhancement plus marcaine

10. Hip Arthroscopy Operative Technique
Fracture Table / Hip Distractor

11. Hip Arthroscopy Operative Technique
Position
Supine – Byrd-Arthroscopy 94
Lateral – Glick-Arthroscopy 87

12. Hip Arthroscopy Operative Technique
Portals
Lateral
Antero Lateral
Postero Lateral – not routinely used

13. Hip Arthroscopy Operative Technique
Technique Supine Position
Foot traction
Well padded perineal post
Lateral distraction - Key

14. Hip Arthroscopy Operative Technique

15. Hip Arthroscopy Operative Technique

16. Hip Arthroscopy Operative Technique
Lateral Portal – 6” 18 gauge spinal needle under fluroscopic guidance

17. Hip Arthroscopy Operative Technique
Seldinger Technique – cannulated obturator and sleeves passed over a wire

18. Hip Arthroscopy Operative Technique

19. 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

20. Hip Arthroscopy Results
Most common reason for arthroscopy
Labral Tear – 70 to 80 percent success rate

21. Hip Arthroscopy

22. Hip Arthroscopy

23. Hip Arthroscopy

24. Hip Arthroscopy

25. Hip Arthroscopy

26. Hip Arthroscopy Complications
Pudendal nerve neurapraxia
Lateral femoral cutaneous neurapraxia
Chondral scuffs from inadequate distration
Sciatic neurapraxia – avoid postero lateral portal

27. Hip Arthroscopy

28. Hip Arthroscopy

29. Hip Arthroscopy

30. Hip Arthroscopy

31. Hip Arthroscopy
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