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International Orthopaedics

, Volume 36, Issue 6, pp 1115–1121 | Cite as

Hip arthroscopy: evolution, current practice and future developments

  • Emmet J. Griffiths
  • Vikas KhandujaEmail author
Review Article

Abstract

Arthroscopic examination and treatment is an ever-increasing part of modern orthopaedic practice in this age of minimally invasive surgery. Arthroscopic procedures have been widespread in surgery of the knee and the shoulder for many years; however, the hip until relatively recently, has been largely neglected. Even now hip arthroscopy is not widely available; this may be due to the complexity of the procedure, the requirement of specialist equipment and a reportedly long learning curve. On the other hand, it has gone through a period of rapid growth over the last decade and is being performed in large numbers routinely in some centres around the world. Hip arthroscopy now provides excellent visualisation of not only the articular surfaces of the hip joint but also of the peritrochanteric or extra-articular space around the hip. Pathology of both the femoral head and the acetabulum along with the soft tissues of the hip, namely the ligamentum teres, the acetabular labrum, the synovial folds and synovium, is readily diagnosed. Modern techniques provide therapeutic options for a myriad of conditions and allow modulation of pathological processes early. Additionally hip arthroscopy is a relatively safe procedure with few complications and contraindications. However, the key to good outcomes is in the careful selection of patients and meticulous surgical technique. The aim of this review is to bring the reader up to date with an overview of the evolution of arthroscopy of the hip, review the current practice and explore possible future developments.

Keywords

Femoral Head Peripheral Compartment Loose Body Labral Tear Iliotibial Band 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Ferguson SJ, Bryant JT, Ganz R et al (2000) The acetabular labrum seal: a poroelastic finite element model. Clin Biomech (Bristol, Avon) 15:463–468CrossRefGoogle Scholar
  2. 2.
    Henak CR, Ellis BJ, Harris MD, Anderson AE, Peters CL, Weiss JA (2011) Role of the acetabular labrum in load support across the hip joint. J Biomech 44:2201–2206PubMedCrossRefGoogle Scholar
  3. 3.
    Field RE, Rajakulendran K (2011) The labro-acetabular complex. J Bone Joint Surg Am 93(Suppl 2):22–27PubMedCrossRefGoogle Scholar
  4. 4.
    Seldes RM, Tan V, Hunt J, Katz M, Winiarsky R, Fitzgerald RH Jr (2001) Anatomy, histologic features, and vascularity of the adult acetabular labrum. Clin Orthop Relat Res 382:232–240PubMedCrossRefGoogle Scholar
  5. 5.
    Kim YT, Azuma H (1995) The nerve endings of the acetabular labrum. Clin Orthop Relat Res 320:176–181PubMedGoogle Scholar
  6. 6.
    McCarthy JC, Noble PC, Schuck MR et al (2001) The watershed labral lesion: its relationship to early arthritis of the hip. J Arthroplasty 16(8 Suppl:1):81–87PubMedCrossRefGoogle Scholar
  7. 7.
    Philippon MJ (2003) Arthroscopy of the hip in the management of the athlete. In: McGinty JB (ed) Operative arthroscopy. Lippincott, Williams & Wilkins, Philadelphia, pp 879–883Google Scholar
  8. 8.
    Nordin M, Frankel VH (2001) Basic biomechanics of the musculoskeletal system, 3rd edn. Lippencott Williams & Wilkins, Philadelphia, pp 208–215Google Scholar
  9. 9.
    Safran MR, Giordano G, Lindsey DP, Gold GE, Rosenberg J, Zaffagnini S, Giori NJ (2011) Strains across the acetabular labrum during hip motion: a cadaveric model. Am J Sports Med 39(Suppl):92S–102SPubMedCrossRefGoogle Scholar
  10. 10.
    Ganz R, Parvizi J, Beck M et al (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop 417:112–120PubMedGoogle Scholar
  11. 11.
    Samirul Imam & Vikas Khanduja. Current Concepts in the diagnosis and Management of Femoroacetabular Impingement. IO 35:1427–1435Google Scholar
  12. 12.
    Beck M, Kalhor M, Leunig M, Ganz R (2005) Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br 87(7):1012–1018PubMedCrossRefGoogle Scholar
  13. 13.
    Kennedy MJ, Lamontagne M, Beaulé PE (2009) Femoroacetabular impingement alters hip and pelvic biomechanics during gait: walking biomechanics of FAI. Gait Posture 30(1):41–44PubMedCrossRefGoogle Scholar
  14. 14.
    Kubiak-Langer M, Tannast M, Murphy SB, Siebenrock KA, Langlotz F (2007) Range of motion in anterior femoroacetabular impingement. Clin Orthop Relat Res 458:117–124PubMedGoogle Scholar
  15. 15.
    Lamontagne M, Kennedy MJ, Beaulé PE (2009) The effect of cam FAI on hip and pelvic motion during maximum squat. Clin Orthop Relat Res 467(3):645–650PubMedCrossRefGoogle Scholar
  16. 16.
    Leunig M, Beck M, Dora C, Ganz R (2005) Femoroacetabular impingement: etiology and surgical concept. Oper Tech Orthop 15(3):247–255CrossRefGoogle Scholar
  17. 17.
    Ito K, Minka MA 2nd, Leunig M, Werlen S, Ganz R (2001) Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br 83(2):171–176PubMedCrossRefGoogle Scholar
  18. 18.
    Burman MS (1931) Arthroscopy or the direct visualisation of joints. J Bone Joint Surg Br 13:669–695Google Scholar
  19. 19.
    Kieser C, Jackson R (2003) Eugen Bircher (1882–1956) the first knee surgeon to use diagnostic arthroscopy. Arthroscopy 19(7):771–776PubMedCrossRefGoogle Scholar
  20. 20.
    Jackson RW (1987) Memories of the early days of arthroscopy: 1965–1975. The formative years. Arthroscopy 3(1):1–3PubMedCrossRefGoogle Scholar
  21. 21.
    Takagi K (1939) The arthroscope: the second report. J Jpn Orthop Assoc 14:441–466Google Scholar
  22. 22.
    Altenberg AR (1977) Acetabular labral tears: a cause of pain and degenerative arthritis. South Med J 70:174–175PubMedCrossRefGoogle Scholar
  23. 23.
    Suzuki S, Awaya G, Okada Y et al (1986) Arthroscopic diagnosis of ruptured acetabular labrum. Acta Orthop Scand 57(6):513–515PubMedCrossRefGoogle Scholar
  24. 24.
    Glick JM, Sampson TG, Gordon RB, Behr JT, Schmidt E (1987) Hip arthroscopy by the lateral approach. Arthroscopy 3:4–12PubMedCrossRefGoogle Scholar
  25. 25.
    Dienst M, Gödde S, Seil R et al (2001) Hip arthroscopy without traction: in vivo anatomy of the peripheral hip joint cavity. Arthroscopy 17(9):924–931PubMedCrossRefGoogle Scholar
  26. 26.
    Voos JE, Ranawat AS, Kelly BT (2009) The peritrochanteric space of the hip. Instr Course Lect 58:193–201PubMedGoogle Scholar
  27. 27.
    Bryd JW, Jones KS (2004) Diagnostic accuracy of clinical assessment, magnetic resonance imaging, magnetic resonance arthrography, and intra-articular injection in hip arthroscopy patients. Am J Sports Med 32(7):1668–1674CrossRefGoogle Scholar
  28. 28.
    McCarthy JC, Lee JA (2006) Hip arthroscopy: indications, outcomes, and complications. Instr Course Lect 55:301–308PubMedGoogle Scholar
  29. 29.
    Byrd JW (1994) Hip arthroscopy utilizing the supine position. Arthroscopy 10:275–280PubMedCrossRefGoogle Scholar
  30. 30.
    Villar RN (1992) The technique of hip arthroscopy. In: Hip arthroscopy. Butterworth-Heinmann, Oxford, pp 39–53Google Scholar
  31. 31.
    Khanduja V, Villar RN (2006) Arthroscopy of the hip: current concepts and recent advances. J Bone Joint Surg Br 88-B:1557–1566CrossRefGoogle Scholar
  32. 32.
    El-Sayed AM (2008) Treatment of early septic arthritis of the hip in children: comparison of results of open arthrotomy versus arthroscopic drainage. J Child Orthop 2(3):229–237PubMedCrossRefGoogle Scholar
  33. 33.
    Rutz E, Brunner R (2009) Septic arthritis of the hip - current concepts. Hip Int 19(Suppl 6):S9–S12PubMedGoogle Scholar
  34. 34.
    Boyer T, Dorfmann H (2008) Arthroscopy in primary synovial chondromatosis of the hip: description and outcome of treatment. J Bone Joint Surg Br 90(3):314–318PubMedCrossRefGoogle Scholar
  35. 35.
    Farjo LA, Glick JM, Sampson TG (1999) Hip arthroscopy for acetabular labral tears. Arthroscopy 15:132–137PubMedCrossRefGoogle Scholar
  36. 36.
    Fitzgerald RH Jr (1995) Acetabular labrum tears. Diagnosis and treatment. Clin Orthop 311:60–68PubMedGoogle Scholar
  37. 37.
    Wenger DE, Kendell KR, Miner MR et al (2004) Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop 426:145–150PubMedCrossRefGoogle Scholar
  38. 38.
    Larson CM, Giveans MR (2009) Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy 25:369–376PubMedCrossRefGoogle Scholar
  39. 39.
    Byrd JW (2001) Lateral impact injury. A source of occult hip pathology. Clin Sports Med 20:801–815PubMedCrossRefGoogle Scholar
  40. 40.
    Robertson WJ, Kadrmas WR, Kelly BT (2007) Arthroscopic management of labral tears in the hip: a systematic review of the literature. Clin Orthop Relat Res 455:88–92PubMedCrossRefGoogle Scholar
  41. 41.
    Crawford K, Philippon MJ, Sekiya JK, Rodkey WG, Steadman JR (2006) Microfracture of the hip in athletes. Clin Sports Med 25:327–335PubMedCrossRefGoogle Scholar
  42. 42.
    O’Donnell JM (2006) Second look arthroscopy after debridement of articular cartilage defects [abstract]. Advances in hip arthroscopy meeting, p 115Google Scholar
  43. 43.
    Byrd JW, Jones KS (2000) Prospective analysis of hip arthroscopy with 2-year follow-up. Arthroscopy 16:578–587PubMedCrossRefGoogle Scholar
  44. 44.
    Lavigne M, Parvizi J, Beck M et al (2004) Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop 418:61–66PubMedCrossRefGoogle Scholar
  45. 45.
    Rao J, Zhou YX, Villar RN (2001) Injury to the ligamentum teres. Mechanism, findings, and results of treatment. Clin Sports Med 20:791–799PubMedCrossRefGoogle Scholar
  46. 46.
    Bardakos NV, Villar RN (2009) The ligamentum teres of the adult hip. J Bone Joint Surg Br 91(1):8–15PubMedCrossRefGoogle Scholar
  47. 47.
    Kelly BT, Williams RJ 3rd, Phillippon MJ (2003) Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med 31:1020–1037PubMedGoogle Scholar
  48. 48.
    Shindle MK, Voos JE, Heyworth BE et al (2007) Hip arthroscopy in the athletic patient: current techniques and spectrum of disease. J Bone Joint Surg Am 89(Suppl 3):29–43PubMedCrossRefGoogle Scholar
  49. 49.
    Wiese M, Rubenthaler F, Willburger RE et al (2004) Early results of endoscopic trochanteric bursectomy. Int Orthop 28:218–221PubMedCrossRefGoogle Scholar
  50. 50.
    Voos JE, Shindle MK, Pruett A, Asnis PD, Kelly BT (2009) Endoscopic repair of gluteus medius tendon tears of the hip. Am J Sports Med 37:743–747PubMedCrossRefGoogle Scholar
  51. 51.
    Jacobson T, Allen WC (1990) Surgical correction of the snapping iliopsoas tendon. Am J Sports Med 18(5):470–474PubMedCrossRefGoogle Scholar
  52. 52.
    Dobbs MB, Gordon JE, Luhmann SJ, Szymanski DA, Schoenecker PL (2002) Surgical correction of the snapping iliopsoas tendon in adolescents. J Bone Joint Surg Am 84(3):420–424PubMedGoogle Scholar
  53. 53.
    Philippon MJ (2001) The role of arthroscopic thermal capsulorrhaphy in the hip. Clin Sports Med 20:817–829PubMedCrossRefGoogle Scholar
  54. 54.
    Clarke MT, Arora A, Villar RN (2003) Hip arthroscopy: complications in 1054 cases. Clin Orthop Relat Res 406:84–88PubMedCrossRefGoogle Scholar
  55. 55.
    Frich LH, Lauritzen J, Juhl M (1989) Arthroscopy in diagnosis and treatment of hip disorders. Orthopedics 12:389–392PubMedGoogle Scholar
  56. 56.
    Griffin DR, Villar RN (1999) Complications of arthroscopy of the hip. J Bone Joint Surg Br 81-B:604–606CrossRefGoogle Scholar
  57. 57.
    Matsuda DK (2009) Acute iatrogenic dislocation following hip impingement arthroscopic surgery. Arthroscopy 25:400–404PubMedCrossRefGoogle Scholar
  58. 58.
    McCarthy JC (2004) Hip arthroscopy: when it is and when it is not indicated. Instr Course Lect 53:615–621PubMedGoogle Scholar
  59. 59.
    Brunner A, Horisberger M, Herzog RF (2009) Evaluation of a computed tomography-based navigation system prototype for hip arthroscopy in the treatment of femoroacetabular cam impingement. Arthroscopy 25:382–391PubMedCrossRefGoogle Scholar
  60. 60.
    Fontana AF (2006) Autologous chondrocyte transplantation [abstract]. Advances in hip arthroscopy meeting, p 185Google Scholar
  61. 61.
    Bajwa AS, Villar RN (2011) Arthroscopy of the hip in patients following joint replacement. J Bone Joint Surg Br 93(7):890–896PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Trauma & Orthopaedic SurgeryAddenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation TrustCambridgeUK

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