J Korean Hip Soc.  2010 Mar;22(1):27-37. 10.5371/jkhs.2010.22.1.27.

Arthroscopy of the Hip Joint: Diagnosis and Treatment

• Hwang DS
• Lee JB

• KMID: 1461074
• DOI: http://doi.org/10.5371/jkhs.2010.22.1.27

Abstract

Hip arthroscopy is technically demanding and requires special distraction tools and operating equipment. The indications for hip arthroscopy are expanding as the understanding of hip disease increases. Improved instrumentation and technical skills have also facilitated the ability of physicians to treat some hip disorders arthroscopically. Various arthroscopic techniques allow the treatment of labral and acetabular rim pathology as well as pathology of the peripheral compartment. Improved techniques and longer-term outcomes studies should further define the optimal role of hip arthroscopy. Consequently, hip arthroscopy has been used to treat patients who should have had a more complicated open procedure or should have gone untreated. Moreover, hip arthroscopy, as with any procedure, is not without risks. Fortunately, complications are few, occurring in <5% of patients with hip pain.

Keyword

Hip; Arthroscopy; Indication; Diagnosis; Treatment

MeSH Terms

Arthroscopy
Hip
Humans

Figure

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  Fig. 1 Schematics of the operating room layout in lateral position.

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  Fig. 2 Commonly used portals in lateral approach. (A) Proximal trochanteric, (B) Anterior paratrochanteric, (C) Posterior paratrochanteric

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  Fig. 3 Serial fluoroscopic images of classic portal insertion method in central compartment. (A) Vacuum seal shadow due to the negative intracapsular pressure is created by distraction of the joint. (B) The needle is inserted and the stylus is removed, then break the seal (C) as in air arthrogram, confirm the lateral labral silhouette. (D) The cannula/obturator assembly is being passed over the guide wire that had been placed through the spinal needle. (E) Then anterior portal is made.

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  Fig. 4 Two compartments (central and peripheral) and normal arthroscopic findings. Acetabular labrum is the boundary to divide the two compartments.

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  Fig. 5 Non-traction technique in hip arthroscopy.

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  Fig. 6 Anterior impingement test. Affected hip is flexed more than 90 degree and adducted, internal rotated maneuver can cause anterior groin pain.

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  Fig. 7 Fluoroscopic image of medial approach.

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  Fig. 8 Osteochondral loose bodies extracted by arthroscopic technique.

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  Fig. 9 Osseous abnormalities resulted in FAI. (A) Pistol grip deformity, (B) Retroverted acetabuli, (C) Coxa vara, (D) Coxa valga.

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