A comprehensive review of hip arthroscopy techniques and outcomes

Abstract

Transforming the orthopedic landscape, hip arthroscopy pioneers a minimally invasive surgical approach for diagnosing and addressing hip pathologies. With its origins dating back to Burman's 1931 cadaveric study, this groundbreaking technique gained clinical relevance in 1939 through Takagi's report. However, the 1980s marked the actual emergence of hip arthroscopy for treating a wide range of hip disorders. Now, a staple in modern orthopedics, hip arthroscopy empowers patients with previously undiagnosed and untreated hip conditions, enabling them to obtain relief and reclaim their lives. By employing a compact camera and specialized tools, surgeons expertly navigate the hip joint, performing procedures from excising loose bodies and mending labral tears to addressing femoroacetabular impingement and tackling other intricate issues. This innovative approach has dramatically elevated patients' quality of life, allowing them to embrace targeted treatments and resume daily activities without resorting to lifestyle alterations.

Keywords: Hip arthroscopy; extra-articular pain syndrome; femoroacetabular impingement syndrome; hip chondral lesions; osteochondral graft.

Figure 1.

Schematic representation of hip. (a) Normal hip, (b) hip with Pincer-type impingement (the red zone represents the acetabular over coverage), and (c) hip with cam-type impingement (the red zone represents the femoral head-neck junction abutment).

Figure 2.

Intraoperative photographs (hip arthroscopy) of the left hip. L: labrum; A: acetabulum; FH: femoral head.

Figure 3.

(a) Intraoperative photographs (hip arthroscopy) of the left hip. (b) Intraoperative photographs (hip arthroscopy) of the right hip. The chondral–labral junction shows a tear and fraying (arrow) at the junction and synovitis at the capsule and labrum as viewed from the lateral portal. L: labrum; A: acetabulum; FH: femoral head.

Figure 4.

(a–c) Schematic representation of labral tears treatments in hip arthroscopy. (a) Labral debridement using a shaver, (b) labral tear repaired using anchors, and (c) labral reconstruction secondary a complete damage of the labrum.

Figure 5.

(a and b) Intraoperative photographs (hip arthroscopy) of the left hip. (a) The femoral head shows cartilage damage (arrow), fraying of the labrum, and synovitis at the capsule as viewed from the lateral portal and (b) the chondral–labral junction shows an area of exposed subchondral bone (arrow). L: labrum; A: acetabulum; FH: femoral head.