3-DIRECTIONAL DIAGNOSTIC AND OPERATIVE ARTHROSCOPY OF THE HIP: TECHNIQUE AND CLINICAL RESULTS

Abstract

We perform arthroscopy of the hip in cases like osteoarthritis, aseptic necrosis of the femoral head, rapidly destructive coxarthrosis to exactly locate the site and extent of the lesion of articular cartilage, acetabulare labrum, and synovial membrane. 381 hips in 279 patients were examined by an arthroscopic technique during the last 16 years. Our technique consists of a three directional approach to the hip joint which facilitates a global view of the joint. This three directional anterior, lateral, and antero-lateral approach means the advantage of the swift replacement of the optical instruments and the easy insertion of arthroscopic tools.

Arthroscopic observation is also very useful for academic purposes. Pathological change of cartilage in osteoarthritis of the hip were classified into 4 grades according to the arthroscopic findings. In 113 joints only biopsies for synovial tissue, cartilage or acetabular limbus were performed. Arthroscopic surgical procedures such as joint debridement for osteoarthritis, synovectomy for rheumatoid arthritis, extraction of loose bodies, release of adhesions between the joint capsule and femoral head, and partial resection of the limbus were also carried out in 60 joints with a mean follow-up of 48 months. Average hip score according to Japanese Orthopedic Association achieved in pain point from 6 points to 24 points. With new improved instruments and three-directional technique, hip arthroscopy is rather easy to perform and less traumatic to the patient therefore we believe that it is suitable procedure for the relief from the coxalgia caused by osteoarthritis, rheumatoid arthritis, and torn limbus.