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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

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Hip Arthroscopy

Frank R. Ebert, M.D.

Union Memorial Hospital

Baltimore, Maryland

hip arthroscopy
Hip Arthroscopy
  • Burman JBJS 1931
    • First published report
hip arthroscopy3
Hip Arthroscopy
  • Level of Acceptance began in 1980’s
hip arthroscopy pre op evaluation
Hip ArthroscopyPre-Op Evaluation
  • Mechanical Symptoms
    • Catching / Locking
    • Pain with hip flexion and internal rotation
  • History of some torsional event about hip
hip arthroscopy indications
Hip ArthroscopyIndications
  • Avascular Necrosis
  • Osteo Arthritis
  • Septic Arthritis
  • Labral Injuries
  • Loose Bodies
  • Foreign Body Retrieval
  • Pediatric Disorders
hip arthroscopy pre op evaluation9
Hip ArthroscopyPre-Op Evaluation
  • Plain radiographs – AP pelvis / Lateral
  • MRI – gadolinium enhancement plus marcaine
hip arthroscopy operative technique
Hip ArthroscopyOperative Technique
  • Fracture Table / Hip Distractor
hip arthroscopy operative technique11
Hip ArthroscopyOperative Technique
  • Position
    • Supine – Byrd-Arthroscopy 94
    • Lateral – Glick-Arthroscopy 87
hip arthroscopy operative technique12
Hip ArthroscopyOperative Technique
  • Portals
        • Lateral
        • Antero Lateral
        • Postero Lateral – not routinely used
hip arthroscopy operative technique13
Hip ArthroscopyOperative Technique
  • Technique Supine Position
    • Foot traction
    • Well padded perineal post
    • Lateral distraction - Key
hip arthroscopy operative technique16
Hip ArthroscopyOperative Technique
  • Lateral Portal – 6” 18 gauge spinal needle under fluroscopic guidance
hip arthroscopy operative technique17
Hip ArthroscopyOperative Technique
  • Seldinger Technique – cannulated obturator and sleeves passed over a wire
hip arthroscopy operative technique19
Hip ArthroscopyOperative 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
Hip ArthroscopyResults
  • Most common reason for arthroscopy
    • Labral Tear – 70 to 80 percent success rate
hip arthroscopy complications
Hip ArthroscopyComplications
  • Pudendal nerve neurapraxia
  • Lateral femoral cutaneous neurapraxia
  • Chondral scuffs from inadequate distration
  • Sciatic neurapraxia – avoid postero lateral portal