Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticlesHip arthroscopy without traction: In vivo anatomy of the peripheral hip joint cavity*
Section snippets
Methods
We performed 35 hip arthroscopies without traction between 1997 and 1999. Each procedure was documented using a standard protocol that included detailed information on normal and pathologic intra-articular findings. Hip arthroscopy of the peripheral compartment of the hip was performed in the supine position from an anterolateral portal (Fig 1).
Arthroscopic anatomy
Similar to the knee joint, the key to an accurate and complete diagnosis of lesions within the hip joint is a systematic approach to viewing. A methodical sequence of examination should be developed, progressing from one part of the joint cavity to another and systematically carrying out this sequence in every hip.
For arthroscopic examination, the peripheral compartment of the hip can be divided routinely into the following areas: anterior neck area, medial neck area, medial head area, anterior
Arthroscopic procedures and complications
In our series of 35 hip arthroscopies without traction, 1 to 3 loose bodies were removed in 3 patients with early osteoarthritis and 40 loose bodies were retrieved in a patient with synovial chondromatosis of the hip. In osteoarthritis, impinging osteophytes were trimmed in 3 patients and partial synovectomy was performed in 10 patients. The following complications were observed: A temporary sensory deficit of the lateral femoral cutaneus nerve was present in 1 patient for 2 days. The cartilage
Discussion
Hip arthroscopy without traction was first introduced by Klapper and Silver in 1989.5 Apparently, only Klapper himself8 and Dorfmann and Boyer2, 4, 9 have continued using this technique. Dorfmann and Boyer2 reported that most of their diagnostic hip arthroscopies were performed without traction. In addition to the role of hip arthroscopy without traction as a diagnostic procedure, therapies such as retrieval of loose bodies, trimming of labral tears, and diagnosis of chondromalacia of the
Acknowledgements
Acknowledgment: The authors thank J. W. Thomas Byrd, M.D., for his advice during the preparation of this report.
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Address correspondence and reprint requests to Michael Dienst, M.D., Department for Orthopaedic Surgery, University Hospital, 66 421 Homburg/Saar, Germany. E-mail: [email protected] Home Page: www.orthopaedie-homburg.de