Hip arthroscopy: the haseki experience

Objective: Hip is a relatively rigid and deep located joint. The role of arthroscopy in diagnosis and treatment of hip and surrounding tissue pathologies has been evaluated along with our clinical experience.
Material and Method: Fifteen hip arthroscopy cases who had admitted to our clinic with antalgic limp and groin pain between 2011 and 2012 were evaluated. Mean age was 35.8 (17-58) years. Three of the patients were female and 12 were male. Preoperative and postoperative Harris hip scores were recorded.
Results: Mean preoperative Harris Hip Score of the cases was 62.7 (54-86) and mean postoperative Harris Hip score was 92.5 (82-100). In three patients CAM type femoro-acetabular impingement was diagnosed and excessive portion of the femoral neck was shaved. In five patients, labral tears were detected. Two were repaired and three were debrided. One patient was diagnosed with osteochondral lesion and treated with reverse mosaicoplasty. Localised avascular necrosis of the femoral head was diagnosed in one patient and anterior mini-open mosaicoplasty was performed. Loose bodies were excised in two patients and intraarticular bullet was extracted in one patient. In two patients, no intraarticular pathology was detected.
Conclusion: When performed by experienced surgeons, hip arthroscopy is a minimal invasive diagnostic and treatment method which has successful results in intraarticular and periarticular hip disorders. Despite the high success rate, neurologic compromise must be avoided by paying meticulous attention in portal selection and by keeping the traction time as short as possible.

Kalça artroskopisi: Haseki deneyimi

Amaç: Anatomik olarak derin yerleþimli ve rijit olan kalça eklemi ve çevresinin patolojilerinin tanýsý ve tedavisinde kalça artroskopisinin yeri irdelendi ve klinik tecrübelerimiz paylaþýldý.
Gereç ve Yöntem: 2011 ve 2012 yýllarý arasýnda kliniðimize aksama ve kasýkta aðrý nedeni ile baþvuran kalça artroskopisi yapýlan hastalar deðerlendirildi. Ortalama yaþ 35.8 (alt-üst sýnýr: 17-58)yýl olan olgularýn üçü bayan, 12’si erkek 15 olgu deðerlendirildi. Olgularýn ameliyat öncesi ve sonrasý Harris kalça skoruna bakýldý.
Bulgular: Olgularýn ortalama Harris kalça skoru ameliyat öncesi 62.7 (54-86) iken, ameliyat sonrasý 92.5 (82-100) olarak saptandý. Üç hastamýzda CAM tipi sýkýþma saptanýp traþlandý, beþ hastada labrum yýrtýðý saptanýp ikisi dikildi, diðerleri debride edildi. Bir hastada osteokondral lezyon(OCD) saptanýp ters mozaikoplasti yapýldý. Bir hastada lokalize femur baþý avasküler nekroz saptanarak anterior mini
açýk mozaikoplasti yapýldý. Ýki hastada eklem içinden serbest cisim, bir hastada eklem içi mermi çýkarýldý. Ýki hastada eklem içi patoloji saptanmadý.
Sonuçlar: Kalça artroskopisi eklem içi ve çevresindeki patolojilerin taný ve tedavisinde deneyimli ellerde yapýldýðý zaman iyi sonuçlar veren minimal invaziv bir taný ve tedavi yöntemidir. Tekniðin baþarýsý yüksek olmakla birlikte nörojenik komplikasyonlar açýsýndan cerrah portal yerleþiminde dikkatli olmalý, traksiyon süresini kýsa tutmaya çalýþmalýdýr.