Athletic hip injuries
Indications for hip arthroscopy are rapidly expanding and include pathology in the central, peripheral, and peritrochanteric compartments. The anterolateral and anterior portals are the primary portals with several described accessory portals. The most common surgical complications include iatrogenic chondrolabral injury, transient neurapraxia, and the inadequate resection of femoroacetabular impingement. The acetabular labrum is a critical structure and should be repaired or reconstructed whenever possible to preserve its function, especially that of creating negative pressure seal to the femoral head. Hip microinstability is proving to be a source of chronic hip pain and disability with several soft-tissue structures, including the ligamentum teres, playing key roles in maintaining stability. Appropriate capsular management, including capsular repair and plication in indicated cases, is proving to be a key step in preserving or establishing hip stability and optimizing surgical outcomes. Tears of the ligamentum teres are a source of pain in the hip and require a high index of suspicion to make the diagnosis. Débridement of partial-thickness ligamentum teres tears has demonstrated good clinical outcomes. Ligamentum teres reconstruction in instability cases may prove to be a useful adjunct along with capsular plication in certain settings but is still unproved at this point.
