2015 ISAKOS Biennial Congress ePoster #804

Can Hip Arthroscopy be Performed with Conventional Knee Length Instrumentation?

Cecilia Pascual-Garrido, MD, Aurora, CO UNITED STATES
Mark Owen Mcconkey, MD, FRCSC, North Vancouver, BC CANADA
Lori A. Nacius, PA, Boulder, CO UNITED STATES
Jonathan T. Bravman, MD, Denver, CO UNITED STATES
Omer Mei-Dan, MD, Boulder, CO UNITED STATES

University of Colorado, Aurora, Colorado, USA

FDA Status Not Applicable

Summary: The distance from skin to socket at 12 and 3 o’clock positions is less than 11cm, suggesting that hip arthroscopy can be performed with conventional knee length instrumentation devices. In obese and overweight patients and patients requiring LT debridement, specific hip arthroscopic tools should be available

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Abstract:

Purpose

To quantify the depth of the joint at three targeted points in the hip through two primary portals utilized during hip arthroscopy.

Methods

116 consecutive hip arthroscopies (104 patients) were included in this study. Age, hip laterality, height (in), weight (lbs), BMI and a subjective assessment of body type (1. muscular, 2. somewhat overweight, 3. overweight, 4. thin, 5. normal) were recorded. Depth from the skin at two portal sites to 3 commonly accessed positions (12 o’clock, 3 o’clock and acetabular fossa) was assessed using a guide with marked notches (in millimeters). Subgroup analysis was performed according to BMI and subjective biotype for each patient.

Results

104 patients with a mean age of 35 years (range 14 – 55 years) were included. Patients were categorized according to BMI: 60% were normal, 22% were overweight, 16% were obese and 2% were underweight. All but 8 procedures were performed with conventional length arthroscopic shavers and burrs. The eight procedures that needed additional hip instrumentation were patients who required LT (ligamentum teres) debridement or those with IP (iliopsoas) tenotomy. Overall, the distance from skin to socket was <11 cm at 12 o’clock and 3 o’clock positions from both anterolateral and anterior portals. Obese and overweight patients had statistically longer distances from skin to socket at all 3 measurements points compared to underweight and normal patients. Considering biotype, the distance from skin to socket in underweight, normal and muscular patients were all equal to or less than 10 cm.

Conclusion

The distance from skin to socket at 12 and 3 o’clock positions is less than 11cm, suggesting that hip arthroscopy can be performed with conventional knee length instrumentation devices. In obese and overweight patients and patients requiring LT debridement, specific hip arthroscopic tools should be available.