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Frank R. Ebert, M.D. Union Memorial Hospital Baltimore, Maryland PowerPoint Presentation
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Frank R. Ebert, M.D. Union Memorial Hospital Baltimore, Maryland

Frank R. Ebert, M.D. Union Memorial Hospital Baltimore, Maryland

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Frank R. Ebert, M.D. Union Memorial Hospital Baltimore, Maryland

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  1. Hip Arthroscopy Frank R. Ebert, M.D. Union Memorial Hospital Baltimore, Maryland

  2. Hip Arthroscopy • Burman JBJS 1931 • First published report

  3. Hip Arthroscopy • Level of Acceptance began in 1980’s

  4. Hip ArthroscopyPre-Op Evaluation • Mechanical Symptoms • Catching / Locking • Pain with hip flexion and internal rotation • History of some torsional event about hip

  5. Hip ArthroscopyIndications • Avascular Necrosis • Osteo Arthritis • Septic Arthritis • Labral Injuries • Loose Bodies • Foreign Body Retrieval • Pediatric Disorders

  6. Hip Arthroscopy

  7. Hip ArthroscopyIndications

  8. Hip ArthroscopyIndications

  9. Hip ArthroscopyPre-Op Evaluation • Plain radiographs – AP pelvis / Lateral • MRI – gadolinium enhancement plus marcaine

  10. Hip ArthroscopyOperative Technique • Fracture Table / Hip Distractor

  11. Hip ArthroscopyOperative Technique • Position • Supine – Byrd-Arthroscopy 94 • Lateral – Glick-Arthroscopy 87

  12. Hip ArthroscopyOperative Technique • Portals • Lateral • Antero Lateral • Postero Lateral – not routinely used

  13. Hip ArthroscopyOperative Technique • Technique Supine Position • Foot traction • Well padded perineal post • Lateral distraction - Key

  14. Hip ArthroscopyOperative Technique

  15. Hip ArthroscopyOperative Technique

  16. Hip ArthroscopyOperative Technique • Lateral Portal – 6” 18 gauge spinal needle under fluroscopic guidance

  17. Hip ArthroscopyOperative Technique • Seldinger Technique – cannulated obturator and sleeves passed over a wire

  18. Hip ArthroscopyOperative Technique

  19. Hip ArthroscopyOperative Technique • Seldinger Technique – antero lateral portal • Line drawn at intersection of ASIS and trochanteric line • 45o cephalad and 30o toward the midline

  20. Hip ArthroscopyResults • Most common reason for arthroscopy • Labral Tear – 70 to 80 percent success rate

  21. Hip Arthroscopy

  22. Hip Arthroscopy

  23. Hip Arthroscopy

  24. Hip Arthroscopy

  25. Hip Arthroscopy

  26. Hip ArthroscopyComplications • Pudendal nerve neurapraxia • Lateral femoral cutaneous neurapraxia • Chondral scuffs from inadequate distration • Sciatic neurapraxia – avoid postero lateral portal

  27. Hip Arthroscopy

  28. Hip Arthroscopy

  29. Hip Arthroscopy

  30. Hip Arthroscopy

  31. Hip Arthroscopy Thank you