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. 2015 Jan 19;4(1):e23-7.
doi: 10.1016/j.eats.2014.10.001. eCollection 2015 Feb.

Intra-articular Fluid Distension for Initial Portal Placement During Hip Arthroscopy: The "Femoral Head Drop" Technique

Kyle Alpaugh  1 , Sangmin R Shin  2 , Scott D Martin  3
Affiliations

Intra-articular Fluid Distension for Initial Portal Placement During Hip Arthroscopy: The "Femoral Head Drop" Technique

Kyle Alpaugh et al. Arthrosc Tech. .

Abstract

Iatrogenic injury is a known complication of initial portal placement during hip arthroscopy. The rate of labral puncture or damage to the articular surfaces with arthroscopic instruments is variable and may be associated with operator inexperience or complex anatomy. In addition, the amount of traction applied to achieve joint distraction may unnecessarily place patients at risk of neurapraxia. The purpose of this article is to describe the "femoral head drop" technique as a method to increase safe access to the central compartment and minimize the amount of traction needed to do so, especially in patients with challenging bony anatomy. This technique uses the application of intra-articular saline solution to cause inferior migration of the femoral head. Intra-articular fluid distension, or the femoral head drop technique, is simple, safe, and reproducible, making it appropriate for hip arthroscopists at any level of experience.

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Figures

Fig 1
Fig 1
Flowchart for performing intra-articular fluid distension. (AP, anteroposterior; ASIS, anterior superior iliac spine.)
Fig 2
Fig 2
(A) Radiolucent vacuum sign (arrow) after minimal traction and before distension. (B) After venting. (C) After distension.
See this image and copyright information in PMC

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