Podium (Sports) 13

A Novel Approach to Hip Arthroscopy

Jonathan Ronquillo, MD, FPOA

An irritable hip in an immune competent adult can be a diagnostic dilemma. Standard tests and examinations may be ambiguous and misleading.

Presenting a sui generis surgical strategy to a 30 year old patient on her first trimester of pregnancy where hip infection was highly suspected.

Due to possible complications with high dose, prolonged antibiotic treatment in a pregnancy at the early stages, and the morbidity encountered in standard open arthrotomy, arthroscopic lavage and debridement were planned after discussion with infectious disease specialist and the

OB-gynecologist. However, hip arthroscopy is usually performed with fluoroscopy, which created another quandary with radiation-related health issues to the foetus.

Thus, to preserve the advantages of a minimal approach with arthroscopy, and avoid radiation exposure, an ultrasound-guided hip arthroscopic approached was performed. Lavage and debridement were done in the usual manner.

The patient exhibited dramatic improvement a day after surgery, with similar improvements in in clinical and infection parameters. This was maintained and continued to improve until final discharge.

Presented is the first procedure to employ ultrasound guidance for the establishment of hip arthroscopic portals. No other reports have noted a similar technique, thus, the novel approach.

It is a viable option and as effective as the standard approach without radiation exposure to both patient and the surgical team.