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Hip Arthroscopy

 

synonyms:

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.

Hip Arthroscopy Indications

Hip Arthroscopy Contraindications

  • Systemic disease precluding anesthesia
  • Local soft-tissue defects / open wounds
  • Osteoporosis
  • Ankylosis
  • Arthrofibrosis
  • 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)
  • Irrigate.
  • 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

  • Post-op:
  • 7-10 Days:
  • 6 Weeks:
  • 3 Months:
  • 6 Months:
  • 1Yr:

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

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