Hip arthroscopy: less invasive technique

The popularity of hip arthroscopy has increased significantly over the past decade. It is technically demanding and may be associated with complications such as iatrogenic damage to the articular cartilage or acetabular labrum, compression injuries to the structures in the perineum, and distraction injuries to the leg. Some of these complications can be avoided by paying meticulous attention to the technique and reducing the traction/surgical time. We describe a technique by which the risk of injury to the articular cartilage may be minimized by introduction of the surgical instruments under direct vision, rather than under radiologic control. The described technique is likely to reduce the operating time by addressing the peripheral-compartment pathologies first-without traction. Traction is only required for the central-compartment procedures. Exposure to ionizing radiation is also diminished (eliminated with practice) because the portals are established under direct vision of the arthroscopist.