Editorial Commentary: What is the Real Story Behind "What Makes Suture Anchor Use Safe in Hip Arthroscopy?"

Reproducibly safe hip suture anchor placement requires clear visualization of the acetabular rim and acetabular articular cartilage and a correct trajectory when the anchor sites and position are selected and when depth stop drilling is done. I favor the lateral decubitus approach over the supine approach and do an extensive capsulotomy for global access to the central and peripheral compartments, thus requiring fewer distraction forces and minimal time spent in the central compartment. My views of the acetabular rim are obtained from the periphery most of the time, and as such, suture anchor drilling and placement are always visualized during simultaneous viewing of both the bony acetabular rim and articular cartilage; thus, the trajectory is targeted with clear visualization of the drill hole from the time of creation to anchor placement. If the drill inadvertently penetrates the articular cartilage, early recognition of a cartilage bulge will allow for backing out and redirection.