Hip arthroscopy: from the beginning to the future--an innovator's perspective.

Hip arthroscopy is one of the fastest-growing areas of orthopaedic surgery. There are many reasons for this, including a better understanding of the pathophysiology of damage to the hip joint, improvements in imaging and technology advancements in arthroscopic instrumentation. This manuscript documents the historical development of hip arthroscopy, in general, as well as advances and ideas that have led to common techniques with regard to portal placement, traction and instrumentation.

Risk of sciatic nerve traction injury during hip arthroscopy—is it the amount or duration? An intraoperative nerve monitoring study.

Background: Using intraoperative nerve monitoring we prospectively studied the prevalence, pattern, and predisposing factors for sciatic nerve traction injury during hip arthroscopy.

Methods: The transcranial motor (tcMEP) and/or somatosensory (SSEP) evoked potentials of seventy-six patients undergoing hip arthroscopy in the lateral position were recorded. Changes in the posterior tibial and common peroneal nerves were evaluated to assess the effects of the amount and duration of traction on nerve function.

Hip arthroscopy by the lateral approach.

Performing hip arthroscopy with the patient in the lateral decubitus position is advantageous in aiding in visualization of the hip joint, in maneuvering instruments in obese patients, and in facilitating entry to the hip joint in patients with spurs on the anterolateral aspect of the acetabulum. The patient is placed in the lateral decubitus position with the hip on which the surgery is being performed on the top. The leg is placed in traction and a well-padded perineal post is applied for countertraction.