Abstract
Aims: Up to 91% of patients have been reported to have bony fragments and debris in the hip joint after reduction of a fracture dislocation (Epstein 1991). Removal of these loose bodies is believed to delay the onset of osteoarthritis and minimize its severity. In some patients, either the good position of the acetabular fracture or excessive comminution of the posterior wall make open removal of the loose bodies a very unattractive procedure. Methods: We present a series of 11 arthroscopic loose bodies removal after fracture dislocation of the hip. The indication for arthroscopic removal was given in the presence of a single fragment in a relatively intact joint, comminution of the posterior wall with a stable hip, impossibility of early ORIF because of associated injuries. Results: In all cases the procedure was performed within the þrst 60 days after dislocation. In none of the cases the acetabular ßoor was interrupted. The procedure took an average of 85 minutes. In two cases arthroscopic removal was not possible and open surgery was required. Conclusions: Arthroscopic removal of loose bodies from the hip is a very demanding procedure. It is indicated only in very selected cases. Problems encountered includes bleeding, difþculties in recognising the normal anatomy and the loose fragment, impossibility to grasp and take out the fragment. We discuss the indications/controindications, and the technical tips to perform a successful removal with this mini-invasive approach.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
