Hip arthroscopy: Peripheral compartment access

Femoroacetabular impingement (FAI) has recently been recognized as a source of hip pain and motion restrictions. Femoral morphology contributes to both cam and pincer FAI and is surgically addressed by accessing the peripheral compartment to restore normal femoral offset and sphericity. One of the more difficult aspects of hip arthroscopy is visualization and treatment of increased femoral head-neck offset and cam lesions in the peripheral compartment. The extracapsular technique explained in this chapter uses the anterior portal, anterolateral portal (ALP), and distal anterolateral access (DALA) portal. These portals allow access to the zona orbicularis and anterolateral aspect of the labrum and femoral neck while giving ergonomic access for cam lesion osteotomies. Moreover, the DALA portal offers the best condition for positioning suture anchors while allowing for an easy additional lengthwise incision of the joint capsule. While several techniques are utilized, the purpose of this chapter is to detail our technique for exposure and 180 A visualization of the femoral neck in the peripheral compartment using a T-capsulotomy.

Duke Scholars

Author Richard Charles Mather III Orthopaedic Surgery