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Hip Arthroscopy: Supine Approach to Patient Positioning, Setup with Post-less

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Hip arthroscopy is performed with the hip distracted with traction for access to the intraarticular structures including the labrum and articular cartilage. Traditional methods of gaining traction utilize a perineal post for countertraction. Forces between 45 and 170 lb may be needed to obtain and maintain traction. This method of traction is reliable for access to the joint but does carry the risk of soft tissue injury in the perineum or nerve injury to the pudendal and other nerves about the perineum. Due to these risks, an alternative method of gaining distraction across the hip joint without the need for a perineal post was created. This method utilizes a Trendelenburg position, with the patient in 10–15°, such that the patient’s body weight in conjunction with specifically designed distraction apparatus acts as counterforce while the operative limb is distracted. The safety and efficacy of this method have been shown. The ability to obtain adequate distraction of 11–20 mm, limited intraarticular iatrogenic complications, no friction-related soft tissue injury, and no compression-related perineal nerve injuries are shown. A small learning curve in operative setup, portal placement, and achieving adequate fluoroscopy views are expected when transitioning from a traditional perineal post distraction system to a post-free method.

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Author information

Authors and Affiliations

  1. Children’s Hospital Colorado Sports Medicine Center, University of Colorado Sports Medicine, Aurora, CO, USA

    Stephanie W. Mayer

  2. Steadman Hawkins Clinic Denver and Department of Orthopedic Surgery, University of Colorado, Aurora, CO, USA

    James W. Genuario

  3. Department of Orthopedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Omer Mei-Dan

Authors
  1. Stephanie W. Mayer
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  2. James W. Genuario
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  3. Omer Mei-Dan
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Corresponding author

Correspondence to Omer Mei-Dan .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Division of Sports Medicine, Section of Young Adult Hip Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Asheesh Bedi

  3. Department of Orthopaedic Surgery, Joint Preservation and Cartilage Restoration Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Center for Hip Preservation Surgery Weill Medical College of Cornell University, Hospital for Special Surgery, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. No affiliation provided

    Allston J. Stubbs

  2. No affiliation provided

    Edward C. Beck

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Mayer, S.W., Genuario, J.W., Mei-Dan, O. (2022). Hip Arthroscopy: Supine Approach to Patient Positioning, Setup with Post-less. In: Nho, S.J., Bedi, A., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-43240-9_123

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  • DOI: https://doi.org/10.1007/978-3-030-43240-9_123

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-43239-3

  • Online ISBN: 978-3-030-43240-9

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