Arthroscopy of the hip.

Arthroscopy of the hip is a relatively new addition to the orthopedic armamentarium. Eriksson, of Sweden, has been a pioneer in studying the force needed to distract the hip joint to allow adequate arthroscopic viewing. Johnson, of Michigan, has provided information on techniques including landmarks, needle positioning and cannula entry. Glick, of California, has described the lateral position for ease of entry of arthroscopic instruments just superior to the greater trochanter. A mini-arthrotomy technique has been used to sublux the femoral head anteriorly from the acetabulum to allow anterior viewing and debridement. An initial series of such procedures in 12 patients resulted in general improvement in symptoms of younger patients with localized articular cartilage defects. Results in older patients with diffuse osteoarthritic changes involving most of the weight-bearing zone of the femoral head were unsatisfactory, however, with most of those patients requiring total hip arthroplasty, within one to two years. Recently, arthroscopy of the hip has been performed in the outpatient surgery department under general endotracheal anesthesia in the lateral decubitus position. Mechanical distraction with 9-18 kg of force has been used routinely, without postoperative neurologic symptoms. Specially adapted long arthroscopes and powered synovial resectors and abraders have been used. In addition, pressurized saline inflow with 100 mmHg of pressure has provided improved joint visualization. Especially helpful has been the availability of angled arthroscopes, including 30 degrees, 60 degrees, and 90 degrees arthroscopes. Potential complications include inadvertent cartilage scuffing, broken instruments, neovascular injury to nearby structures, and local infection. Systemic complications such as pulmonary embolus must always by considered.(ABSTRACT TRUNCATED AT 250 WORDS)