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Hip Arthroscopy for Femoroacetabular Impingement

intermediate Level

Primary Indication

Symptomatic FAI (cam, pincer, or combined) with preserved joint space

Danger Structures

  • undefined (Variable - depends on specific approach and fracture pattern) - Deep to surgical field
  • undefined (Immediately medial to anterior inferior iliac spine) - Medial to hip joint and femoral shaft
  • undefined (5-10mm medial to piriformis at notch) - Posterior to hip joint, exits greater sciatic notch

Visual Atlas

No anatomy Images Yet

We're currently sourcing high-quality anatomy diagrams for this procedure.

Step-by-Step Technique

1

Supine: traction applied with perineal post

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
2

Anterolateral portal: fluoroscopic guidance, 1cm anterior and superior to GT tip

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
3

Mid-anterior portal: intersection of vertical line from ASIS and horizontal from GT tip

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
4

Central compartment first (requires traction):

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
5

Inspect labrum, chondral surfaces, ligamentum teres

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
6

Pincer resection: acetabuloplasty with burr at rim

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
7

Labral repair with suture anchors or labral reconstruction if not repairable

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
8

Release traction for peripheral compartment:

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
9

Cam resection: osteochondroplasty of head-neck junction

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
10

Burr to create spherical head-neck junction

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
11

Fluoroscopic guidance to confirm adequate resection

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
12

Dynamic assessment for residual impingement

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures
13

Capsular closure vs release depends on instability risk

Surgeon's Tip
EXAM KEY: Critical step in procedure execution. Understand rationale and potential complications.
Danger Zone
  • Iatrogenic injury to adjacent structures