B

Figure 45-16 A, Peripheral compartment viewing superiorly. B, Demonstrated is the anterior portion of the joint including the articular surface of the femoral head (FH), anterior labrum (AL), and the capsular reflection (CR). (A, Courtesy of Smith & Nephew Endoscopy, Andover, MA. B, Courtesy of J.W. Thomas Byrd, MD, Nashville, TN.)

Figure 45-17 A, Peripheral compartment viewing medially. B, Demonstrated are the femoral neck (FN), medial synovial fold (MSF), and the zona orbicularis (ZO). (A, Courtesy of Smith & Nephew Endoscopy, Andover, MA. B, Courtesy of J.W. Thomas Byrd, MD, Nashville, TN.)

Figure 45-18 The arthroscope and shaver are positioned within the iliopsoas bursa directly over the lesser trochanter, identifying the fibers of the iliopsoas tendon (IT) at its insertion site. (Courtesy of J.W. Thomas Byrd, MD, Nashville, TN.)

Iliopsoas Bursoscopy

Positioning

Flexion is slightly less (15 to 20 degrees) than that used to view the peripheral compartment. The hip is also externally rotated, which moves the lesser trochanter more anterior and accessible to the portals.

Portals

Two portals are needed for viewing and instrumentation within the bursa (Fig. 45-18). These portals are distal to those used for the peripheral compartment and require fluoroscopy for precise positioning. These portals may be slightly more anterior to completely access the area of the lesser trochanter.

Loose Bodies

Removal of symptomatic loose bodies is not the most common indication for hip arthroscopy, but it is the clearest indication. Loose bodies can be extracted and arthroscopy offers an excellent alternative to arthrotomy, previously indicated for this condition (Fig. 45-19).11-13 Most problematic loose bodies reside in the intra-articular compartment and are addressed with standard arthroscopic methods. However, many may remain hidden in the peripheral compartment and later become troublesome.

Figure 45-19 A 20-year-old male with a 3-month history of acute left hip pain. A, Anteroposterior radiograph demonstrates findings consistent with old Legg-Calve-Perthes disease. B, Lateral view defines the presence of intra-articular loose bodies (arrows).

Figure 45-19 A 20-year-old male with a 3-month history of acute left hip pain. A, Anteroposterior radiograph demonstrates findings consistent with old Legg-Calve-Perthes disease. B, Lateral view defines the presence of intra-articular loose bodies (arrows).

Was this article helpful?

0 0
Cure Tennis Elbow Without Surgery

Cure Tennis Elbow Without Surgery

Everything you wanted to know about. How To Cure Tennis Elbow. Are you an athlete who suffers from tennis elbow? Contrary to popular opinion, most people who suffer from tennis elbow do not even play tennis. They get this condition, which is a torn tendon in the elbow, from the strain of using the same motions with the arm, repeatedly. If you have tennis elbow, you understand how the pain can disrupt your day.

Get My Free Ebook


Post a comment