An aiming guide for anterior portal placement in hip arthroscopy

Hip arthroscopy has become a standard surgical procedure. Specific portals and portal placement techniques are well described and routinely used. The anterior portal placement relies on the ability of the surgeon to introduce a needle into the joint from the landmark located at the crossing of a vertical line from the anterior superior iliac spine and a horizontal line from the greater trochanter. Directing the needle at 30 degrees medially and 45 degrees proximally is recommended, but some adjustment is always necessary to access the joint. Multiple punctures are often needed to place the needle in the correct path into the hip. This increases the risk of injury by puncture of the structures adjacent to the site of the anterior portal and increases surgical time. This study reports the use of a guide device we developed to assist anterior portal placement. The device consists of an intra-articular probe attached to an extra-articular aiming guide that introduces the needle into the hip joint. The needle enters at the previously described landmark and is directed towards the tip of the probe inside the joint. Early clinical results are presented.