Operative hip arthroscopy.

Twenty patients underwent operative arthroscopic procedures of the hip joint. All procedures were performed with the patient in the supine position on a standard fracture table using fluoroscopy through three arthroscopic portals (anterolateral, anterior paratrochanteric, and posterior paratrochanteric). The initial indications were therapeutic in 16 patients: loose bodies in four, synovial chondromatosis in three, rheumatoid arthritis in five, ankylosing spondylitis in one, septic arthritis in one, avascular necrosis of femoral head in one, and primary osteoarthritis in one. In four patients who had unexplained hip pain, the initial indications were diagnostic: minimal synovial change was seen in two patients, a synovial chondromatosis was present in another, and a tear of the acetabular labrum and hypertrophy of ligament teres were present in a fourth patient. In one patient who had primary osteoarthritis, the insertion of the arthroscopic instrument into the hip joint failed because of profuse osteophytes along the acetabular rim. Twelve of the 19 patients showed significant improvement of the symptoms after the arthroscopic procedure, but seven patients had no benefit from the procedure. One patient had a postoperative reflex sympathetic dystrophy.