Clin Orthop Surg.  2015 Sep;7(3):392-395. 10.4055/cios.2015.7.3.392.

Usefulness of the Medial Portal during Hip Arthroscopy

• Kang C
• Hwang DS
• Hwang JM
• Park EJ

• KMID: 2234096
• DOI: http://doi.org/10.4055/cios.2015.7.3.392

Abstract

The current conventional portals for hip arthroscopic surgery are the anterior, anterolateral, and posterolateral portals. For lesions in the medial anteroinferior or posteroinferior portion of the hip, these portals provide insufficient access to the lesion and consequently lead to incomplete treatment. Thus, in such a situation, a medial portal approach might be helpful. However, operators have avoided this procedure because of the risk of injury to the obturator, femoral neurovascular structures, and the medial femoral circumflex artery. Thus, to overcome the disadvantages of the conventional method for medial lesions of the hip, we performed a cadaveric study to evaluate the technique, usefulness, and risk of the medial portal technique.

Keyword

Hip; Arthroscopy; Medial portal

MeSH Terms

Aged
Arthroscopy/*instrumentation/*methods
Female
Hip Joint/*surgery
Humans
Male
Middle Aged
Patient Positioning

Figure

• 

  Fig. 1 Positioning for hip arthroscopy. (A) Initial draping includes painting the medial aspect of the hip joint and covering it with disinfected sheets. (B) Insertion of the medial portal. The left side of the photograph is the lateral aspect and the right side of the photograph is the medial aspect.

• 

  Fig. 2 The surface anatomy of the hip joint in a cadaveric study. The middle points of the anterior and posterior borders of the adductor longus were set as A2 and B2, respectively, and the points on the posterior border of the adductor longus were set as A3 and B3. A needle for spinal anesthesia was inserted at each point.

• 

  Fig. 3 The actual anatomy of the hip joint of a cadaver. The spinal needle was inserted as described in Fig. 2.

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  Fig. 4 (A) Intraoperative image taken with the image intensifier. (B) The position of the operator.

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