[Current status of diagnostic and surgical hip arthroscopy]

Due to the anatomy and topography of the hip, clinical diagnostic procedures are often not very significant. Even the use of highly technical examination methods mostly does not allow differentiation of specific hip problems and do not give exact information about the extent and stage of the lesion. This applies specifically for rheumatoid diseases. Arthroscopy of the hip joint, like other big joints of the extremities, closes this diagnostic gap. Directly visualized findings on the joint, in addition to the results of joint aspiration and histological biopsies, give one security in finding the right diagnosis and planning adequate therapy. The conventional surgical approach to the hip joint leads to large wounds and to corresponding risks and damage to the patient. The advantages of arthroscopy are obvious. It was shown that arthroscopic surgery can be used very efficiently in cases with loose-body, osteochondrosis dissecans, scattered cartilage fragments, or septic arthritis. The other therapeutic application is in cases with rheumatoid arthritis where an arthroscopically assisted synovectomy to the hip achieves a high rate of success without temporary luxation. Diagnostic arthroscopy and arthroscopic surgery to the hip have been used in the Orthopedic Department of the University of Ulm since autumn of 1984. The possibilities and limitations of this surgical procedure have been evaluated in more than 100 cases. Based on our experience with arthroscopy on hip joints, we think that this procedure is very helpful for making a diagnosis and administering therapy.