Hip Arthroscopy- Surgery

Exploration of the Hip

Hip arthroscopy allows for the visualization of peripheral, deep, and periarticular joint structures, and for performing a dynamic evaluation of movement.
A normal peripheral compartment includes the absence of effusion or foreign body, non-inflammatory smooth synovium, smooth and flexible peripheral labrum surface with fine vessels, well-notched head-neck junction, and absence of femoral osteophyte. During dynamic tests, the absence of femoroacetabular impingement should be verified.

The deep compartment includes smooth and flexible acetabular cartilage and femoral dome cartilage, the deep side of the labrum continuous with the acetabular cartilage, non-inflammatory background of the acetabulum, continuous round ligament, and absence of osteophyte.

Normal periarticular structures include the continuous non-inflammatory psoas tendon, in its serous bursa or communicating with the peripheral hip. The insertions of the gluteal tendons (not routinely explored) normally present without rupture, calcification, or bursitis.

Therapeutic Procedures

Following the diagnostic assessment phase, the operator may perform one or more of the following therapeutic procedures:

• Removal of a femoral cam by femoroplasty
• Removal of an acetabular pincer by acetabuloplasty
• Repair or resection of an acetabular labrum lesion
• Resection of an unstable cartilaginous flap
• Subchondral Pridie perforations
• Debridement of a round ligament lesion
• Localized or extensive synovectomy
• Removal of chondromas or other foreign bodies
• Procedures on the psoas, tenotomy, or debridement

Biopsies may be performed for bacteriological and histological purposes depending on the situation. The duration of the procedure varies from 45 minutes to 2 hours, depending on the situation.