Hip Arthroscopy CPT
- 29860 Arthroscopy, hip, diagnostic with or without synovial boipsy
- 29861 Arthroscopy, hip, with removal of loose body or foreign body
- 29862 Arthroscopy, hip, with debridement/shaving of articular cartilage
- 29863 Arthroscopy, hip, with synovectomy
- 29914 Arthroscopy, hip, with femoroplasty (treatment of cam lesion)
- 29915 Arthroscopy, hip, with acetabuloplasty (treatment of pincer lesion)
- 29916 Arthroscopy, hip, with labral repair
Hip Arthroscopy Anatomy
- Anterolateral portal risks injury to Superior gluteal nerve.
- Anterior portal risk injury to the LFCN and femoral neurovascular bundle. (Byrd JW, Pappas JN, Pedley MJ. Hip arthroscopy: an anatomic study of portal placement and relationship to the extra-articular structures. Arthroscopy. 1995 Aug;11(4):418-23. )
Hip Arthroscopy Indications
Hip Arthroscopy Contraindications
- Systemic disease precluding anesthesia
- Local soft-tissue defects / open wounds
- Severe obesity
Hip Arthroscopy Alternatives
- Nonop treatment
- Open treatment
Hip Arthroscopy Planning / Special Considerations
- Hip flexion allows access to the peripheral compartment.
- C-arm; fracture table or custom distraction device is required.
Hip Arthroscopy Technique
- Sign operative site.
- Pre-operative antibiotics, +/- regional block.
- General endotracheal anesthesia
- Lateral decubitus(better for obese patients) or supine position. All bony prominences well padded.
- Examination under anesthesia.
- Prep and drape in standard sterile fashion.
- Anterolateral portal (small risk to superior gluteal nerve)
- Posterolateral portal (risks sciatic nerve)
- Anterior portal (risks lateral femoral cutaneous nerve, less risk to femoral artery and nerve)
- Close in layers.
Hip Arthroscopy Complications
- Traction neuropraxia
- Fluid extravasation: intra-abdominal
- Iatrogenic chondral injury
- Lateral femoral cutaneous nerve palsy
- Other rare nerve palsies: Sciatic, pudendal, femoral.
Hip Arthroscopy Follow-up care
- 7-10 Days:
- 6 Weeks:
- 3 Months:
- 6 Months:
Hip Arthroscopy Outcomes
Hip Arthroscopy Review References
- Byrd JW, JAAOS 2006;14:433 (video available)
- Byrd JW, ICL 2003;52:701-730
- McCarthy JC, JAAOS 1995;3:115