Hip arthroscopy via a peripheral compartment first capsular-preserving technique: a step-by-step description

Hip arthroscopy is a well-recognized procedure for the treatment of several hip pathologies. Different methods of arthroscopic access to the hip have been published. The most popular approach is the central compartment first technique, where the first portal to the central compartment is placed under traction and fluoroscopic control. This technique, however, carries the risk of iatrogenic damage to the cartilage and labrum, especially when adequate distraction cannot be obtained. In addition, secondary exposure of the peripheral compartment frequently requires larger capsulotomies. The current article is to describe an alternative arthroscopic approach to the hip with the peripheral compartment being first accessed. The peripheral compartment first technique offers the advantages of a limited capsular release for peripheral compartment exposure and a reduced risk of iatrogenic cartilage and labrum damage during subsequent central compartment portal placement.