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Two Broad CategoriesTwo Broad CategoriesAlternative to arthrotomyfor traditionally recognized forms of hip pathology Method of management for conditions that previously wereunrecognized and untreated:Loose bodiesSepsisArthritisPatients simply resigned to living within the constraints of their symptomsLabral tearsArticular injuriesRuptured ligamentum teresAnatomyLabrum and AcetabulumAdvantages of HipArthroscopyLabrumSoft rimCircumferentialAcetabulumDeepConcentricLig. TeresLess invasive vs..arthrotomyAllows surgeon to addressintraarticular derangementsthat were previouslyundiagnosed/untreatedRecent InterestPatient Assessment and SymptomsArthroscopic equipmentadaptations have led toimproved safety &visualizationImproved surgicaltechniquesBetter understanding ofanatomy andbiomechanics of hip jointImproved imagingtechniquesCharacteristic Exacerbations Symptoms worse with activities Straight plane activities relatively well-tolerated Twisting, such as turning changing directions Seated position may be uncomfortable,especially with hip flexion Rising from seated position often painful (catching) Difficulty ascending and descending stairs Symptoms with entering/exiting an automobile Difficulty with shoes, socks, hose, etc. (OA)2
Specific TestsSpecific Tests “C” sign Standing W/B rotation Log roll –intraarticular pathology Thomas testflexion contracture Forced Flex/IR“impingement test” Flexion/ABD/ERlabral/surface diseaseclicks - associated with labralpathology Resisted SLRlabral/surface disease“C” signStanding W/B rotationLog rollintraarticular pathologyThomas testflexion contractureForced Flex/IR“impingement test”Flexion/ABD/ERlabral/surface diseaseclicks - associated with labralpathologyResisted SLRlabral/surface diseaseSpecific TestsSpecific Tests“C” signStanding W/B rotationLog rollintraarticular pathologyThomas testflexion contractureForced Flex/IR“impingement test”Flexion/ABD/ERlabral/surface diseaseclicks - associated with labralpathologyResisted SLRlabral/surface disease“C” signStanding W/B rotationLog rollintraarticular pathologyThomas testflexion contractureForced Flex/IR“impingement test”Flexion/ABD/ERlabral/surface diseaseclicks - associated with labralpathologyResisted SLRlabral/surface diseaseSpecific Tests“C” signStanding W/B rotationLog rollintraarticular pathologyThomas testflexion contractureForced Flex/IR“impingement test”Flexion/ABD/ERlabral/surface diseaseclicks - associated with labralpathologyResisted SLRlabral/surface diseaseRadiographic investigationXR’s:s: Poorly indicative of problemsamenable to arthroscopic interventionMcCarthy & Busconi, Orthop ‘9595Insensitive indicator of early OASantori & Villar, Orthop ‘993
Page 4 and 5: Radiographic investigation Helpful
Page 6 and 7: IndicationsIndicationsLoose bodiesL
Page 8 and 9: XR imagingXR imagingXR imagingPoste
Page 10 and 11: Labral tearsLabral tears Twisting i
Page 12: Cam TypeFAI - Cam type Impingement
Page 15 and 16: FAI - Pincer typePincer typeImpinge
Page 17 and 18: Chondral DamageChondral Damage Acut
Page 19 and 20: Osteochondritis DissecansOsteochond
Page 21 and 22: ConclusionsConclusionsLABRAL TEARS:
Page 23: Post OPPost OP10 days10 daysPost op

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