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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.

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

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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.