AANA Fellowship Education - Hip Arthroscopy: Peripheral Compartment-Hip Arthroscopy: Peripheral Compartment

Video Transcription

Video Summary

The Anna Fellows webinar featured leading hip arthroscopy experts Drs. Noh, Nachoku, and a prerecorded session by Dr. Philippon, focusing on peripheral compartment issues in femoroacetabular impingement (FAI) and capsular management. Dr. Noh discussed CAM deformity pathomechanics and emphasized the importance of preoperative planning using standard X-rays and, when needed, 3D CT imaging to understand deformity morphology. Proper surgical access, commonly via interportal or T-shaped capsulotomy—with traction stitches to improve visualization—is essential for thorough resection. He highlighted reproducible intraoperative fluoroscopic imaging at varying hip positions for precise resection and postoperative confirmation, avoiding incomplete correction which leads to failure.<br /><br />Dr. Nachoku reviewed capsulotomy types, advocating T-shaped capsulotomy for better exposure and iliofemoral ligament preservation but stressed either interportal or T-cut is acceptable if the capsule is completely closed. He emphasized capsular suspension techniques during surgery to preserve tissue and ease closure. Complete capsular closure correlates with better outcomes and less scarring compared to partial closure.<br /><br />Dr. Philippon’s prerecorded talk focused on peripheral compartment access, dynamic hip positioning for optimal visualization and resection, and avoidance of over- or under-resection, noting the importance of capsular closure and reconstruction in cases with capsule deficiency.<br /><br />The panel discussed imaging strategies, generally favoring MRI to assess cartilage and labrum, with CT reserved for complex or large CAM morphology cases to aid 3D understanding. Surgical approaches combine fluoroscopy and dynamic intraoperative exams for balanced, precise resection. They also addressed challenging cases involving sub-spine impingement, advocating visualization and capsule preservation.<br /><br />Overall, the webinar reinforced meticulous preoperative imaging, strategic access, dynamic intraoperative assessment, and thorough capsular management as keys to successful hip arthroscopy outcomes.

Asset Caption

Thomas H. Wuerz, M.D., M.Sc. | Mark J. Philippon, M.D. | Shane J. Nho, M.D., M.S. | Benedict U. Nwachukwu, M.D.

Keywords

hip arthroscopy

femoroacetabular impingement

CAM deformity

capsulotomy techniques

capsular management

preoperative imaging

fluoroscopic imaging

capsular closure

dynamic hip positioning

sub-spine impingement