Medial Hip Arthroscopy Portals: An Anatomic Study

Polesello, Giancarlo Cavalli; Fernandes, André Eugênio Omine; Oliveira, Liszt Palmeira de; Linhares, João Paulo Tavares; Queiroz, Marcelo Cavalheiro de

doi:10.1016/j.arthro.2013.09.004

Cited by 12 publications

(17 citation statements)

References 13 publications

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“…A medial portal also can be used for posterior cam resection, as described by Polesello et al 7 While this Make a generous transverse capsulotomy, which can be closed at the end of the case If on preoperative physical examination the patient cannot get at least 75 of external rotation in a FABER position, anticipate that this approach will be difficult, and probably require a larger capsulotomy. Most traction devices allow some flexion and extension of the hip.…”

Section: Discussionmentioning

confidence: 99%

“…Among these techniques are additional portal placements, namely a posterolateral portal, which has increased risk for injury at the sciatic nerve, an approach that works from anterior to lateral to posterior, as described by Matsuda and Hanami, 6 or use of a medial portal, as described by Polesello et al 7 We present a strategy that uses the traditional modified anterior and anterolateral portals, but with the addition of a pre-bent bur. This technique also allows for dynamic testing to test the resection and reduce the risk of persistent impingement.…”

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confidence: 99%

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Posterior Femoral Cam Decompression Through an Arthroscopic Anterior Approach With Pre-Bent Hip Burrs

Ochiai

Costales

Riley

et al. 2020

Arthroscopy Techniques

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Hip arthroscopy has been increasingly used to treat labral tears and cam and pincer lesions found in femoroacetabular impingement. Although the classic impingement with cam deformity at the proximal femoral anterolateral quadrant is most common, there has been evidence of cam impingement extension to the anteromedial and posterior quadrants of the proximal femur. Posterior cam decompression carries a theoretical risk of vascular insult and subsequent osteonecrosis, which have led investigators to approach these posterior lesions through an open surgical correction. Recent improvements have led to the development of pre-bent burs that allow for bonier resection flexibility. Here, we report on an arthroscopic posterior cam decompression using the traditional anterior portals and curved hip burs via a figure-of-four positioning technique.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Posterior Femoral Cam Decompression Through an Arthroscopic Anterior Approach With Pre-Bent Hip Burrs

Ochiai

Costales

Riley

et al. 2020

Arthroscopy Techniques

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“…6 Medial portals have also been described to access the joint described as anterior, posterior and distal posterior to the adductor longus. 7 …”

Section: Positioning and Portalsmentioning

confidence: 99%

The current situation in hip arthroscopy

et al. 2017

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Hip arthroscopy is an evolving surgical technique that has recently increased in popularity.Although femoroacetabular impingement was an important launch pad for this technique, extra-articular pathology has been described through hip endoscopy.Good clinical results in the medium term will allow improvements in this technique and increase its indications.Cite this article: EFORT Open Rev 2017;2:58-65. DOI: 10.1302/2058-5241.2.150041

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“…The medial portals studied were: Anterior Medial Portal (AMP), Posterior Medial Portal (PMP) and Distal Posterior Medial Portal (DPMP). For the medial portals, the cadaver was placed in a supine position with a thigh abduction of 70º and a flexion of 70º, applying a full external rotation (Polesello et al, 2014). Fluroscopy (fluoroscopy C-arm KMC 950 brand-eat) was used to confirm and evaluate the effectiveness of intracapsular distention and placement of each portal (Fig.…”

Section: Methodsmentioning

confidence: 99%

Neurovascular Structures at Risk During Anterolateral and Medial Arthroscopic Approaches of the Hip

et al. 2016

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MÉNDEZ-AGUIRRE, O.; MORALES-AVALOS, R.; COMPEÁN-MARTÍNEZ SUMMARY:To describe the safety areas for placement of 5 anterolateral portals (anterior, anterior lateral, posterior lateral, proximal anterior medial and distal anterior medial portals) and 3 recently described medial portals (anterior medial, posterior medial and distal posterior medial portals) to provide topographical description of the safety of each. A descriptive, observational and crosssectional study in which femoral triangle dissection was performed in 12 hips. 5 lateral portals and the 3 medial portals were placed. Clinically relevant neurovascular structures associated with each portal, were identified measured and documented. The lateral portal with the highest risk of injury to a nearby neurovascular structure was the anterior portal, the most adjacent to the femoral cutaneous nerve, 1.42 cm (±0.85) lateral to the portal. In the medial portals, the anterior medial portal has the narrowest margin in relation to the femoral artery, 2.14 cm (±0.35) lateral to the portal and medial to the obturator nerve by 0.87 cm (±0.62). The lateral portals have a higher safety margin; the portal with the most proximity to a neurovascular structure is the anterior portal, associated laterally with the femoral cutaneous nerve, presenting a higher risk of injury. Medial portals have a higher risk of injuring the femoral neurovascular bundle as well as the obturator nerve.

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Medial Hip Arthroscopy Portals: An Anatomic Study

Cited by 12 publications

References 13 publications

Posterior Femoral Cam Decompression Through an Arthroscopic Anterior Approach With Pre-Bent Hip Burrs

Posterior Femoral Cam Decompression Through an Arthroscopic Anterior Approach With Pre-Bent Hip Burrs

The current situation in hip arthroscopy

Neurovascular Structures at Risk During Anterolateral and Medial Arthroscopic Approaches of the Hip

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