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Hip Arthroscopy: The Peripheral Compartment

Chapter

Abstract

When performing hip arthroscopy, the hip can be divided into three compartments: central, peripheral, and peritrochanteric. The central compartment is intra-articular, and is made up of the acetabular fossa and lunate cartilage, ligamentum teres, and the loaded articular surface of the femoral head. The peripheral compartment of the hip is separated from the central compartment by the labrum. The peripheral compartment is extra-articular yet intra-capsular, and consists of the femoral head’s unloaded cartilage, femoral neck with synovial folds (anterior, medial, and lateral), and the articular capsule of the hip joint. The zona orbicularis, also known as ligament of Weibrecht, is a thickening of the hip joint capsule which wraps around the femoral neck, forming a ring around the neck’s circumference, and is the narrowest area within the capsule [1]. It is thought to enhance hip stability with distraction and is an important landmark in peripheral compartment arthroscopy. There are also four capsular-ligamentous complexes (iliofemoral, quadrupedal, ischiofemoral, posterior) that contribute to hip stability, that have ill-defined borders [2]. The peritrochanteric compartment lies between the iliotibial band and the proximal femur providing access to the insertion of the gluteus medius and minimus.

Keywords

Femoral Head Peripheral Compartment Anterolateral Portal Femoral Head Neck Junction Femoral Head Neck 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Ito H, Yongnam S, Lindsey DP, Safran MR, Giori NJ. The proximal hip joint capsule and the zona orbicularis contribute to hip joint stability in distraction. J Orthop Res. 2009;27(8):989–95.PubMedCrossRefGoogle Scholar
  2. 2.
    Fuss FK, Bacher A. New aspects of the morphology and function of the human hip joint ligaments. Am J Anat. 1991;192:1–13.PubMedCrossRefGoogle Scholar
  3. 3.
    Byrd JWT, Pappas J, Pedley MJ. Hip arthroscopy: an anatomic study of portal placement and relationship to the extra-articular structures. Arthroscopy. 1995;11:418–23.PubMedCrossRefGoogle Scholar
  4. 4.
    Robetson WJ, Kelly BT. The safe zone for hip arthroscopy: a cadaveric assessment of central, peripheral, and lateral compartment portal placement. Arthroscopy. 2008;24(9):1019–26.CrossRefGoogle Scholar
  5. 5.
    Safran MR. Arthroscopic femoral osetoplasty. In: Sekiya J, Safran MR, Leunig M, Ranawat AS, editors. Techniques in hip arthroscopy and joint preservation surgery. Philadelphia: Elsevier Saunders; 2010. p. 159–72.Google Scholar
  6. 6.
    Deinst M, Godde S, Seil R, Hammer D, Kohn D. Hip arthroscopy without traction: in vivo anatomy of the peripheral hip joint cavity. Arthroscopy. 2005;17:924–31.CrossRefGoogle Scholar
  7. 7.
    Bond JL, Zakary AK, Ebert A, Guanche CA. The 23-piont arthroscopic examination of the hip: basic setup, portal placement, and surgical technique. Arthroscopy. 2009;25(4):416–29.PubMedCrossRefGoogle Scholar
  8. 8.
    Sampson TG. Arthroscopic treatment of femorocetabular impingement: a proposed technique with clinical experience. Instr Course Lect. 2006;55:337–46.PubMedGoogle Scholar
  9. 9.
    Ferguson SJ, Bryant JT, Ganz R, Ito K. An in vitro investigation of the acetabular labral seal in hip joint mechanics. J Biomech. 2003;36(2):171–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Brunner A, Horisberger M, Herzog RF. Evaluation of a computed tomography-based navigation system prototype for hip arthroscopy in the treatment of femoroacetabular cam impingement. Arthroscopy. 2009;25(4):382–91.PubMedCrossRefGoogle Scholar
  11. 11.
    Stahelin L, Stahelin T, Jolles BM, Herzog RF. Arthroscopic offset restoration in femoroacetabular cam impingement: accuracy and early clinical outcome. Arthroscopy. 2008;24(1):51–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Vaughn ZD, Safran MR. Arthroscopic femoral osteoplasty/chielectomy for cam type femoracetabular impingement in the athlete. Sports Med Arthrosc Rev. 2010;18(2):90–9.CrossRefGoogle Scholar
  13. 13.
    Mardones RM, Gonzalez C, Chen Q, Zobitz M, Kaufman KR, Trousdale RT. Surgical treatment of femoracetabular impingement: evaluation of the effect of the size of resection. J Bone Joint Surg Am. 2005;87(A):273–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Alpert JM, Kozanek M, Guoan L, Kelly BT, Asnis PD. Cross-sectional analysis of the iliopsoas tendon and its relationship to the acetabular labrum. An anatomic study. Am J Sports Med. 2009;37(8):1594–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Chandler SB. The iliopsoas in man. Anat Rec. 1934;58(3):235–40.CrossRefGoogle Scholar
  16. 16.
    Byrd JWT. Evaluation and management of the snapping iliopsoas tendon. Tech Orthop. 2005;20:45–51.CrossRefGoogle Scholar
  17. 17.
    Ilizaliturri VM, Villalobos FE, Chiadez PA, Valero FS, Aguilera JM. Internal snapping hip syndrome: treatment by endoscopic release of the iliopsoas tendon. Arthroscopy. 2005;21:1375–80.PubMedCrossRefGoogle Scholar
  18. 18.
    Wettstein M, Jung J, Dienst M. Arthroscopic psoas tenotomy. Arthroscopy. 2006;22(8):907.e1–4.CrossRefGoogle Scholar
  19. 19.
    Ilizaliturri VM, Chaidez C, Villegas P, Briseno A, Camacho-Galindo J. Prospective randomized study of 2 different techniques for endoscopic iliopsoas tendon release in the treatment of internal snapping hip syndrome. Arthroscopy. 2009;25(2):159–63.PubMedCrossRefGoogle Scholar
  20. 20.
    Clarke MT, Arora A, Villar RN. Hip arthroscopy: complications in 1054 cases. Clin Orthop Relat Res. 2003;406(1):84–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Sampson TG. Complications of hip arthroscopy. Tech Orthop. 2005;20(1):63–6.CrossRefGoogle Scholar
  22. 22.
    Funke EL, Munzinger U. Complications in hip arthroscopy. Arthroscopy. 1996;12:156–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Sher DL, Belmont Jr PJ, Owens BD. Case report: osteonecrosis of the femoral head after hip arthroscopy. Clin Orthop Relat Res. 2010;468(11):3121–5.CrossRefGoogle Scholar
  24. 24.
    Bartlett CS, DiFelice GS, Buly RE, Quinn TJ, Green DS, Helfet DL. Cardiac arrest as a result of intra-abdominal extravasation of fluid during arthroscopic removal of a loose body from the hip joint of a patient with an acetabular fracture. J Orthop Trauma. 1998;12:294–300.PubMedCrossRefGoogle Scholar
  25. 25.
    Byrd JW, Jones KS. Prospective analysis of hip arthroscopy with 2-year follow-up. Arthroscopy. 2000;16:578–87.PubMedCrossRefGoogle Scholar
  26. 26.
    Kim SJ, Choi NH, Kim HJ. Operative hip arthroscopy. Clin Orthop. 1998;353:156–65.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Division of Orthopaedic SurgeryThe Ottawa Hospital, University of OttawaOttawaCanada
  2. 2.Adult Reconstruction ServiceUniversity of OttawaOttawaCanada

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