Computer-Assisted Hip Arthroscopy for Portal Establishment and Suture Anchor Placement

Hip arthroscopy is the gold standard for treating femoroacetabular impingement syndrome and acetabular labral tears. Portal establishment and suture anchor placement are crucial steps for ensuring the success of the surgery. However, because of the complex anatomy, deep location, and narrow joint space of the hip joint, the learning curve for establishing the hip arthroscopy approach and placing suture anchors for labral repair is arduous, with a high risk of iatrogenic cartilage and labral damage. This article describes a solution that applies computer-assisted navigation to these 2 key steps. Based on the patient's preoperative computed tomography data, this technique enables the reconstruction of an individualized 3-dimensional skeletal model, on which the clockface target of the anterolateral portal at the acetabular rim and the placement sites of suture anchors for labral repair are precisely planned. Intraoperatively, high-precision spatial registration between the preoperative virtual plan and the patient's actual anatomical structure is achieved via 2-dimensional to 3-dimensional image registration. With the assistance of the navigation system, the surgeon can accurately establish the arthroscopic portal in a single attempt without fluoroscopy and safely perform acetabular suture anchor placement for subsequent labral suture.