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Hip Arthroscopy

 

synonyms: hip scope, 

Hip Arthroscopy CPT

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
  • 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