Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K....

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Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N. Mintz, Luis E. Moya, Robert L. Buly, and Bryan T. Kelly J Bone Joint Surg Am Volume 89(suppl 3):29-43 October 1, 2007 ©2007 by The Journal of Bone and Joint Surgery, Inc.

Transcript of Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K....

Page 1: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease

by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N. Mintz, Luis E. Moya, Robert L. Buly, and Bryan T. Kelly

J Bone Joint Surg AmVolume 89(suppl 3):29-43

October 1, 2007

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Anteroposterior radiograph demonstrating the method for measuring the Tönnis angle of the hip.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Anteroposterior radiograph demonstrating the method for measuring the center-edge angle of Wiberg.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Anteroposterior radiograph of the pelvis, demonstrating the crossover sign that is indicative of a retroverted acetabulum.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 11: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 12: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 13: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 14: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 15: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 16: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 17: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 18: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Sagittal fast-spin-echo (cartilage-sensitive) magnetic resonance image demonstrating an anterior labral tear (arrow) after a posterior subluxation.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 19: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 20: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 21: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 22: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 23: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 24: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 25: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 26: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Treatment algorithm for the management of traumatic dislocation or subluxation of the hip in athletic patients.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 27: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Intraoperative photograph of a left hip with the portals in place.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 28: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Arthroscopic image of the insertion of the gluteus maximus tendon (arrow) onto the linea aspera.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 29: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Arthroscopic image of a left hip, demonstrating the hip abductors (arrow) and the iliotibial band (arrowhead).

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 30: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Arthroscopic image of a left hip after release of the iliotibial band in a z-type manner to treat external coxa saltans.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 31: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Arthroscopic image of a left hip, demonstrating the insertion of the gluteus medius onto the greater trochanter (arrow).

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.

Page 32: Hip Arthroscopy in the Athletic Patient: Current Techniques and Spectrum of Disease by Michael K. Shindle, James E. Voos, Benton E. Heyworth, Douglas N.

Arthroscopic image of the gluteus medius and its tendon captured with sutures after they are passed sequentially through the edges of the prepared tendon with a suture-passing device.

Michael K. Shindle et al. J Bone Joint Surg Am 2007;89:29-43

©2007 by The Journal of Bone and Joint Surgery, Inc.