APEX Hip Enhancing Clinical Expertise and Proficiency (November 2023)-Hip Access: Distraction, Fluoroscopy, and Portal Placement

Hip Access: Distraction, Fluoroscopy, and Portal Placement

Video Transcription

Video Summary

Dr. Winston Gwathe discusses safe and effective OR setup for hip arthroscopy, emphasizing table selection that allows traction, fluoroscopy, and manipulation. He describes positioning techniques, including use of perineal posts and postless tables, and highlights the importance of padding and countertraction. Fluoroscopy guides portal placement to avoid damaging the labrum and neurovascular bundles, stressing careful needle insertion and use of anatomical landmarks. Bevel orientation during portal creation minimizes labral and cartilage injury. Safe portal placement ensures good visualization and instrument maneuverability. He advocates dry joint access initially to avoid bleeding, concluding with readiness for hip repair and encouraging questions.

Asset Caption

Winston Gwathmey, M.D.

Keywords

hip arthroscopy

OR setup

table selection

fluoroscopy guidance

portal placement