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ABCs for Starting Hip Arthroscopy

March 01, 2019

Contributors: Manish Mehta; Thomas Sean Lynch, MD; Thomas Sean Lynch, MD

This video reviews preoperative planning and operating room management for hip arthroscopy with an emphasis on specific techniques that are applicable to large academic medical centers and smaller private practice settings. In addition, the video highlights the importance of team management and preoperative coordination with other staff to increase intraoperative efficiency. The video begins by reviewing the key components of the surgical plan, including preoperative checklists to facilitate equipment accessibility and a schematic for suggested operating room layout. Next, the video demonstrates the ideal operating room layout and proper patient positioning to ensure accurate portal placement and entry into the hip joint. Specific recommendations on surgical table setup; modifications to patient protective equipment; and recommendations on common perioperative necessities, such as anesthesia and fluoroscopy management, are discussed. Commonly encountered pitfalls and their technical solutions in the form of clinical pearls are discussed throughout the video. Suggested setup of arthroscopic equipment and surgical site markings prior to incision are illustrated. The video then discusses a systematic technique for entry into the hip joint. The video concludes by demonstrating successful entry into the hip joint. As the number of arthroscopic hip procedures continues to rise, careful instruction of orthopaedic surgeons and trainees on preoperative planning as well as operating room management and organization is paramount to decrease the risk of iatrogenic intraoperative complications, maximize operating room efficiency, and improve patient-reported outcomes.

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