[Arthroscopy of the hip. Methods and values].

The authors report on their experience with 225 arthroscopies of the hip (performed in 241 patients from January 1983 through September, 1991). Only 15 arthroscopies were performed using traction. For 228 procedures they used their simplified method without traction which does not visualize the congruent cartilage surfaces or acetabular fossa. To determine whether this method ensures a satisfactory diagnostic and therapeutic approach to the hip, 100 patients belonging to three groups (normal arthroscopy, indeterminate diagnosis, and chondromatosis) were sent a questionnaire on one to three occasions. Follow-up at the time of the first questionnaire was at least six months. Mean follow-up was 3 years (range 8 to 83 months). Arthroscopic diagnosis was based on direct evidence for the peripheral part of the joint and indirect evidence for lesions of the congruent joint surfaces and acetabular fossa. Sixty four responses were obtained, rates of error were only 5% for patients with normal arthroscopies and 22% for those with indeterminate arthroscopies (i.e., the group with the highest potential for error). Therapeutic results with the simplified method were satisfactory in 40% (15/35) of patients with chondromatosis; however, 7 of 44 patients (16%) had a repeat arthroscopy which was unsuccessful in more than half the cases (4/7). No complications or technical failures occurred in this series. In conclusion, simplified arthroscopy without traction is advocated as the routine arthroscopy procedure for investigating and treating hip disorders. The conventional technique with traction remains necessary when imaging procedures (especially the CT scan or arthroscan) demonstrate lesions of the congruent articular surfaces or acetabular fossa.