Congress Proceedings

How to start with hip arthroscopy in a safe and effective manner, using an evidence-based approach

¹ Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
² Department of Trauma and Orthopedics, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK
³ Mount Elizabeth Novena Hospital, 38 Irrawaddy Road, Singapore 329563, Singapore
⁴ Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg 413 45, Sweden
⁵ Department of Orthopedics, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry 605502, India
⁶ Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
⁷ Department of Orthopaedics and Traumatology, Kasr Alainy Hospital, Cairo Univerity, Cairo 11562, Egypt
⁸ The Institute of Orthopaedics “Carlos E. Ottolenghi”, Italian Hospital of Buenos Aires, Buenos Aires C1181ACH, Argentina
⁹ Orthopaedic Surgery and Traumatology Department, University Hospital Infanta Leonor, Madrid 28031, Spain
¹⁰ Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium

^* Corresponding author: emmanuel.audenaert@ugent.be

Received: 17 May 2024
Accepted: 2 August 2024

Abstract

Hip arthroscopy is a rapidly evolving field in orthopedics, offering diagnostic and therapeutic benefits for a range of hip pathologies. This review outlines a comprehensive guide to initiating hip arthroscopy safely and effectively using evidence-based practices. Optimal surgical outcomes depend on correct indications for surgery, in particular in the presence of borderline dysplasia and degenerative joint diseases. Proper patient counseling and setting realistic expectations are crucial for satisfactory outcomes and recovery. Physical examination, radiographs, MRI, and CT scans are essential for accurate diagnosis. In case of diagnostic uncertainty, the use of intra-articular injections can help confirm the diagnosis before surgery. Techniques for hip arthroscopy include central compartment first, peripheral compartment first, and outside-in approaches. Each technique has advantages, and the optimal approach depends on the specific case. Finally, Proper operating room setup, meticulous patient positioning, and precise portal placement are critical for a successful procedure. A thorough understanding of the safe zone anatomy for portal placement is essential to minimize the risk of neurovascular complications. In conclusion, this manuscript provides a detailed, evidence-based framework for starting hip arthroscopy, emphasizing the importance of technical proficiency, patient selection, and a multidisciplinary approach to ensure patient safety and procedure efficacy.