hip arthroscopy

Question 1

Indications and contraindications for hip arthroscopy

Answer 1

Indications:
* FAI - labral tears, chondral injuries, impinging osteophytes
* loose bodies
* synovial disease
* AVN

Question 2

theatre set up, portals and hazards

Answer 2

Set up
* supine tractio table with well padded perineal post
* 50lb traction
* joint distention with saline
* 70 deg scope and dilators

portals
* Anterolateral - main viewing portal - 2cm ant/ sup GT tip
* Posterolateral - 2cm post GT tip - posterior hip
* Anterior portal - intersection of superior ridge of the GT and ASIS - central compartment
* distal anterolateral 5cm below AL portal - for peripheral compartment

Question 3

what are the three anatomical compartments

Answer 3

• intra-articular central - chondral lesions - acetabular fossa, rim, labrum, LT , capsule
• intra-articular peripheral - cam lesions - head/neck junction, iliopsoas tendon
• extra-articular - tendons; piriformis, gluts, hamstrings

Question 4

what are the relevant complications

Answer 4

• chondrolabral injury from scope- most common
• hip instability - iatrogenic capsular insufficiency
• pudendal nerve - most common - perineal post tract
• Superior gluteal nerve - anterolateral portal
• sciatic nerve - posterolateral portal
• lateral femoral cutaneous nerve - anterior portal
• fluid extravasation