My name is Jorge Chala, and we're going to demonstrate the arthroscopic anatomy during hip arthroscopy. We will start by demonstrating the structures of the central compartment while the hip is in full extension. First, visualization of the anterior acetabular wall, anterior labrum, and sosium, or anterior labral sulcus, located at the three o'clock face view of a right hip, can be performed via the anterior lateral portal. Next, we shift the attention for enhanced assessment of the articulating lunate surface and the cotyloid fossa, which contains the ligamentum teres and its six acetabular attachments lying over the fovea capitis on top of the femoral head. We can then zoom in into the anterior horn of the cotyloid fossa and sosium, which corresponds to a concave impression on the anterior acetabular rim. We can also appreciate the stellate crease, presenting as a slit-like fiber cartilaginous area located at the 1230 to 1 o'clock position of the lunate cartilage. As we zoom out, we are able to appreciate part of the capsule, previously in size for creation of the interporeal capsulotomy, which overlies on top of the labrum on the left and the femoral head on the right. We now pass to the peripheral compartment, starting with locating the 50% yard line of the iliofemoral ligament for creation of the T portion of the capsulotomy, which extends down to the soni orbicularis. The femoral head-neck junction is then exposed. Zooming out, we get a better appreciation of the femoral neck and the soni orbicularis. We then are able to see the retinacular vessels and branches of the medial femoral circumflex artery on the posterior superior aspect of the greater trochanter along the lateral synovial fold. The arthroscope is then shifted to assess the medial synovial fold, which corresponds as a reliable landmark for ensuring adequate access to the peripheral compartment. We finalize by demonstrating the suction seal of the acetabulum femoral head, generated by the repaired labrum.

hip arthroscopy

central compartment

anterior acetabular wall

iliofemoral ligament

femoral head-neck junction