Arthroscopic Resection of Intra-Articular Osteochondromas of the Hip

Self Cite

Hip arthroscopy with initial access to the peripheral compartment represents a specific technique to approach the hip that can be particularly useful. This technique is suitable for both the arthroscopic treatment of femoroacetabular impingement syndrome and other pathologies that can be addressed by classic arthroscopy with central compartment initial access. Minimal capsulotomies preserve the fluid pressure in the peripheral compartment, which allows the "ballooning" of the capsule and improved joint exposure with decreased risk of fluid extravasation. In the vast majority of cases, the hip joint can be accessed by any technique depending on the surgeon preference/expertise. Interestingly, access to the central compartment under direct arthroscopic visualization decreases the risk of iatrogenic labral and chondral damage. This is particularly important when access to the central compartment is technically challenging (e.g., acetabular overcoverage, labral hypertrophy, and limited joint distraction). Such a technique is also preferable if the pathology is mainly located in the peripheral compartment. Despite several advantages, hip arthroscopy with initial access to the peripheral compartment is not a commonly performed technique. Our purpose is to perform a step-by-step explanation of a previously described technique.

Section: Discussionmentioning

confidence: 99%

Hip Arthroscopy With Initial Access to the Peripheral Compartment: A Detailed Step-by-Step Technique Description

Dantas

Gonçalves

Mascarenhas

et al. 2020

Self Cite

“…To date, few studies have described the use of hip arthroscopy for resection of proximal femoral osteochondromas 2, 6, 7, 8, 10. Wang et al 2 .…”

Section: Discussionmentioning

confidence: 99%

“…The authors did not provide any description of capsular repair, if any, and it is unknown whether these patients developed instability at longer follow-up. Another recent case report of a patient with 2 intra-articular osteochondromas and an AL labral tear was described in which the authors used hip arthroscopy to resect the lesions 10 . Interestingly, these authors first addressed the lesions in the peripheral compartment without traction, as opposed to first entering the central compartment, which is not routine.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Femoral Osteochondroplasty With Capsular Plication for Osteochondroma of the Femoral Neck

Alter

Okoroha

Kunze

et al. 2019

Osteochondromas of the femoral neck are a rare but challenging problem because of their distal location, which is difficult to access arthroscopically. Traditional methods of osteochondroma resection used invasive open approaches to manage these lesions. More recently, advances in hip arthroscopy have allowed expanded treatment of extra-articular hip conditions with a minimally invasive approach. Reports have described the use of hip arthroscopy for osteochondroma removal; however, surgical techniques for the procedure have yet to be described. We describe a technique for arthroscopic resection of a femoral neck osteochondroma using an extended capsulotomy and osteochondroplasty with subsequent capsular plication. This technique uses contemporary hip arthroscopic techniques and constitutes a safe and effective approach to addressing this rare intra-articular pathology of the hip.

“…The least amount of traction possible is used as we establish access to the central compartment from the peripheral compartment (anterolateral portal) under direct arthroscopic control (proximal anterolateral portal) with the use of a switching stick (anterior portal) to push the lateral capsule. 7 , 9 …”

Section: Surgical Techniquementioning

confidence: 99%

Is It Safe to Perform an Early Arthroscopy After a Traumatic Hip Dislocation With an Associated Pelvic Ring Injury? Report of Our Technique

Geada

Dantas

Mascarenhas

et al. 2018

Self Cite

Hip arthroscopy is useful in the treatment of several intra-articular pathologies, however, its use in high-energy hip and pelvis injuries raises concerns about fluid extravasion and stability of the pelvic ring. We present our arthroscopic surgical technique (initial access to the peripheral compartment) to remove intra-articular loose bodies and treat associated lesions, as well as our concerns with the technique, in case of a traumatic hip dislocation associated with a contralateral pelvic ring injury.