Ultrasound-Guided Establishment of Hip Arthroscopy Portals

Abstract 

We describe ultrasound-guided establishment of hip arthroscopy portals. The surface projections of anatomic structures around the hip joint (including the nerve, vessels, femoral neck, and acetabulum) were marked. The entry points were then planned for the anterolateral and anterior portals and, if necessary, the posterolateral portal. The anterolateral portal was first placed. Through the use of real-time ultrasound guidance, a pin was inserted into the hip joint and 20 mL of normal saline solution was injected. A K-wire was then inserted into the joint space over the needle. The arthroscopic trocar was introduced along the K-wire, and the arthroscope was inserted to confirm the establishment. The anterior portal was then established. The hip joint was flexed slightly. The previous procedure was duplicated to insert the K-wire. The path of the pin was confirmed by viewing from the arthroscope in the anterolateral portal. If necessary, the posterolateral portal was established by the same procedure.

Key Words: Ultrasound guidance, Hip, Arthroscopy, Portal