455J.W.T. Byrd (ed.), Operative Hip Arthroscopy, DOI 10.1007/978-1-4419-7925-4, © Springer Science+Business Media New York 2013

Appendix: Protocols

456 Acetabuloplasty

457Acetabuloplasty

458 Acetabuloplasty

459Acetabuloplasty

460 Acetabuloplasty

461Acetabuloplasty

462 Acetabuloplasty

463Acetabuloplasty

464 Acetabuloplasty

465Acetabuloplasty

466 Acetabuloplasty

467Acetabuloplasty

468 Femoroplasty

469Femoroplasty

470 Femoroplasty

471Femoroplasty

472 Femoroplasty

473Femoroplasty

474 Femoroplasty

475Femoroplasty

476 Femoroplasty

477Femoroplasty

478 Femoroplasty

479Femoroplasty

480 Femoroplasty

481Hip Luxation

482 Iliopsoas Release

483Iliopsoas Release

484 Iliopsoas Release

485Iliopsoas Release

486 Iliopsoas Release

487Iliopsoas Release

488 Iliopsoas Release

489Iliopsoas Release

490 Iliopsoas Release

491Iliopsoas Release

492 Iliopsoas Release

493Iliopsoas Release

494 Iliopsoas Release

495Labral Repair

496 Labral Repair

497Labral Repair

498 Labral Repair

499Labral Repair

500 Labral Repair

501Labral Repair

502 Labral Repair

503Labral Repair

504 Labral Repair

505Labral Repair

506 Labral Repair

507Microfracture

508 Microfracture

509Microfracture

510 Microfracture

511Microfracture

512 Microfracture

513Microfracture

514 Microfracture

515Microfracture

516 Microfracture

517Microfracture

518 Microfracture

519Microfracture

520 Routine Arthroscopic Procedure

521Routine Arthroscopic Procedure

522 Routine Arthroscopic Procedure

523Routine Arthroscopic Procedure

524 Routine Arthroscopic Procedure

525Routine Arthroscopic Procedure

526 Routine Arthroscopic Procedure

527Routine Arthroscopic Procedure

528 Routine Arthroscopic Procedure

529Routine Arthroscopic Procedure

530 Routine Arthroscopic Procedure

531Routine Arthroscopic Procedure

532 Routine Arthroscopic Procedure

533Routine Arthroscopic Procedure

534 Appendix: Acetabuloplasty Exercises

Page Exercise Link to video demonstration

P. 455 Ankle pump http://goo.gl/1KTvU Glut sets http://goo.gl/sx4Ze

P. 456 Quad sets http://goo.gl/NKRg6 Heel slides, active-assisted range of motion http://goo.gl/2zYZ2 Hamstring sets http://goo.gl/cPku0 Log rolling http://goo.gl/GJHvs Adductor isometrics http://goo.gl/ZmlWZ Pelvic tilt http://goo.gl/8rHkO

P. 457 Trunk rotation http://goo.gl/nO9ob Seated knee extensions http://goo.gl/HOSmk Double leg bridges http://goo.gl/GrbI0 Prone on elbows http://goo.gl/Cb7OJ Weight shifts - sitting, supported, anterior/posterior, lateral http://goo.gl/QF6un Prone knee fl exion http://goo.gl/OdaSb

P. 458 Standing abduction without resistance http://goo.gl/xvSH2 Standing fl exion without resistance http://goo.gl/y0HjG Standing adduction without resistance http://goo.gl/Qt9MN Standing extension without resistance http://goo.gl/WVYwP Pain dominant hip mobilization, grades I, II http://goo.gl/pJ1OY

P. 459 Abduction isometrics http://goo.gl/k2zB3 Seated physioball progression - knee extension http://goo.gl/Qj0b2 1/4 mini squats http://goo.gl/xiTd4 Hip fl exion, IR/ER in pain-free range http://goo.gl/h7Ktd Standing heel lifts http://goo.gl/TbHu0 Theraband resistance on affected side - abduction (start very low resistance) http://goo.gl/skh1u

P. 460 Theraband resistance on affected side - adduction (start very low resistance) http://goo.gl/zWFGC Superman http://goo.gl/U0CBw Theraband resistance on affected side - fl exion (start very low resistance) http://goo.gl/IshHg Theraband resistance on affected side - extension (start very low resistance) http://goo.gl/NvZnN

P. 461 Stiffness dominant hip mobilization - grades III, IV http://goo.gl/MQEFE Stiffness dominant hip mobilization - grades III, IV http://goo.gl/GAWJz Clamshells (pain-free range) http://goo.gl/mBydg Leg raise - Abduction http://goo.gl/BfKa8 Leg raise - Extension http://goo.gl/yjNad Double leg bridges to single leg bridges http://goo.gl/6Iuk8

P. 462 Shuttle leg press 90 degree hip fl exion with co-contraction of adductors http://goo.gl/BCpCe Seated physioball progression - hip fl exion http://goo.gl/rwov6 Dead bug http://goo.gl/KzAVu Forward walking over cups and hurdles (pause on affected limb), add ball toss while walking http://goo.gl/LxCsl Quadriped 4 point support, progress 3 point support, progress 2 point http://goo.gl/WeS8g

P. 463 Crunches http://goo.gl/2jcQx Standing theraband/pulley weight - Abduction http://goo.gl/P1J9h Bosu squats http://goo.gl/m5mFL Standing theraband/pulley weight - Adduction http://goo.gl/mUOHd

P. 464 Standing theraband/pulley weight - Flexion http://goo.gl/IshHg Clamshells with theraband http://goo.gl/RxWsS Standing theraband/pulley weight - Extension http://goo.gl/cpxNY Sidestepping with resistance (pause on affected limb), sports cord walking forward and backward (pause on affected limb)

http://goo.gl/5ylq3

Single leg balance - fi rm to soft surface http://goo.gl/7YV8S P. 465 Leg press (gradually increasing weight) http://goo.gl/BCpCe

Superman on physioball - 2 point on physioball http://goo.gl/ThWMa Physioball hamstring exercises - hip lift, bent knee hip lift, curls, balance http://goo.gl/kLYq5

Acetabuloplasty Exercises

535Links to Video Demonstration

P. 466 Step-ups with eccentric lowering http://goo.gl/TaaDa Side steps over cups/hurdles (with ball toss and external sports cord resistance), increase speed http://goo.gl/pv6ci Lunges pogress from single plane to tri-planar, add medicine balls for resistance and rotation http://goo.gl/syM2y Single leg body weight squats, increase external resistance, stand on soft surface http://goo.gl/JXYV7 Theraband walking patterns http://goo.gl/g7XQG

P. 467 Single leg pick-ups, add soft surface http://goo.gl/eiVQL

536 Appendix: Femoroplasty Exercises

Page Exercise Link to video demonstration

P. 468 Weight shifts - sitting, supported, anterior/posterior, lateral http://goo.gl/osBPR Ankle pumps http://goo.gl/GaA2R

P. 469 Seated knee extensions http://goo.gl/Otgh7 Hamstring sets http://goo.gl/DHONr Glut sets http://goo.gl/XSMYP Adductor isometrics http://goo.gl/xDXeC Quad sets http://goo.gl/28hCV Heel slides, active-assisted range of motion http://goo.gl/JUcgU

P. 470 Log rolling http://goo.gl/1OczB Double leg bridges http://goo.gl/Fl9Yh Pelvic tilt http://goo.gl/Fl9Yh Prone on elbows http://goo.gl/LlC83 Trunk rotation http://goo.gl/nO9ob Prone knee fl exion http://goo.gl/dJEgn

P. 471 Standing abduction without resistance http://goo.gl/WDm5n Standing fl exion without resistance http://goo.gl/ZoPKO Standing adduction without resistance http://goo.gl/Yjq9S Pain dominant hip mobilization, grades I, II http://goo.gl/pJ1OY Standing extension without resistance http://goo.gl/nzb00

P. 472 Supine marching, modi fi ed dead bug http://goo.gl/RB505 Theraband resistance on affected side - abduction (start very low resistance) http://goo.gl/IlCPc Abduction isometrics http://goo.gl/rw3x7 Theraband resistance on affected side - adduction (start very low redsistance) http://goo.gl/lYNtO Superman http://goo.gl/Sf4kc Theraband resistance on affected side - fl exion (start very low resistance) http://goo.gl/IshHg

P. 473 Theraband resistance on affected side - extension (start very low resistance) http://goo.gl/NvZnN 1/4 mini squats http://goo.gl/Ap5Pd Hip fl exion, IR/ER in pain-free range http://goo.gl/wdnUS Standing heel lifts http://goo.gl/ZO6Yb Double leg bridges to single leg bridges http://goo.gl/3k6zE

P. 474 Clamshells (pain-free range) http://goo.gl/uckKA Quadriped 4 point support, progress 3 point support, progress 2 point http://goo.gl/vWgWT Leg raise - Abduction http://goo.gl/Bwzed Seated physioball progression - hip fl exion http://goo.gl/0WPPj Leg raise - Extension http://goo.gl/yjNad Hip mobilization - inferior glides in fl exion http://goo.gl/MQEFE

P. 475 Stiffness dominant hip mobilization - grades III, IV http://goo.gl/HRrZV Crunches http://goo.gl/VZ3qT Standing theraband/pulley weight - Abduction http://goo.gl/E5CPE

P. 476 Standing theraband/pulley weight - Adduction http://goo.gl/KleNf Single leg balance - fi rm to soft surface http://goo.gl/ni9hg Standing theraband/pulley weight - Flexion http://goo.gl/Ne fl L Shuttle leg press 90 degree hip fl exion with co-contraction of adductors http://goo.gl/BCpCe Standing theraband/pulley weight - Extension http://goo.gl/hQylz Clamshells with theraband http://goo.gl/Jgsb6

P. 477 Forward walking over cups and hurdles (pause on affected limb, add ball toss while walking http://goo.gl/VNF4i Lateral walking over cups and hurdles (pause on affected limb), add ball toss while walking http://goo.gl/kvdW6 Leg press (gradually increasing weight) http://goo.gl/BCpCe Physioball hamstring exercises - hip lift, bent knee hip lift, curls, balance http://goo.gl/sMdX3

P. 478 Superman on physioball - 2 point on physioball http://goo.gl/Gom9f Sidestepping with resistance (pause on affected limb), sports cord walking forward and backward (pause on affected limb)

http://goo.gl/5ylq3

Bosu squats http://goo.gl/WAU49

Femoroplasty Exercises

537Links to Video Demonstration

P. 479 Step-ups with eccentric lowering http://goo.gl/BUHvx Side steps over cups/hurdles (with ball toss and external sports cord resistance), increase speed http://goo.gl/LZ2U1 Lunges progress from single plane to tri-planar, add medicine balls for resistance and rotation http://goo.gl/V4S0T Single leg body weight squats, incerase external resistance, stand on soft surface http://goo.gl/NzbKh Theraband walking patterns http://goo.gl/3ovrA

P. 480 Single leg pick-ups, add soft surface http://goo.gl/RzSrr

538 Appendix: Iliopsoas Release Exercises

Page Exercise Link to video demonstration

P. 482 Seated knee extensions http://goo.gl/BY5ec Seated weight shifts http://goo.gl/LkxoY

P. 483 Ankle pumps http://goo.gl/ZgqKk Hamstring sets http://goo.gl/oB8PN Glut sets http://goo.gl/Eiq9M Adductor isometrics http://goo.gl/gE9UF Quad sets http://goo.gl/cJcBG Heel slides, active-assisted range of motion http://goo.gl/txSao

P. 484 Log rolling http://goo.gl/nAOjL Double leg bridges http://goo.gl/417CV Pelvic tilt http://goo.gl/417CV Prone on elbows http://goo.gl/LlC83 Trunk rotation http://goo.gl/nO9ob Prone knee fl exion http://goo.gl/Iz4kH

P. 485 Standing abduction without resistance http://goo.gl/0IrpB Standing fl exion without resistance http://goo.gl/QbtFl Standing adduction without resistance http://goo.gl/eyU9i Pain dominant hip mobilization, grades I, II http://goo.gl/pJ1OY Standing extension without resistance http://goo.gl/nzb00

P. 486 Abduction isometrics http://goo.gl/rw3x7 Superman http://goo.gl/CspFC 1/4 mini squats http://goo.gl/3mf4I Theraband resistance on affected side - abduction (start very low resistance) http://goo.gl/E5CPE Standing heel lifts http://goo.gl/TUekm Theraband resistance on affected side - adduction (start very low resistance) http://goo.gl/lYNtO

P. 487 Theraband resistance on affected side - fl exion (start very low resistance) ONLY IF TOLERATED http://goo.gl/IshHg Theraband resistance on affected side - extension (start very low resistance) http://goo.gl/NvZnN Stiffness dominant hip mobilization (left photo) http://goo.gl/MQEFE Stiffness dominant hip mobilization (right photo) http://goo.gl/Br94X

P. 488 Double leg bridges to single leg bridges http://goo.gl/Xng3v Leg raise - Extension http://goo.gl/yjNad Clamshells (pain-free range) http://goo.gl/uckKA Shuttle leg press 90 degree hip fl exion with co-contractionof adductors http://goo.gl/BCpCe Leg raise - Abduction http://goo.gl/dbj0t Dead bug http://goo.gl/Vy5F3

P. 489 Quadriped 4 point support, progress 3 point support, progress 2 point http://goo.gl/ExPJN Lateral walking over cups and hurdles (pause on affected limb), add ball toss while walking http://goo.gl/FiYvY Seated physioball progression - hip fl exion http://goo.gl/rwov6 Forward walking over cups and hurdles (pause on affected limb), add ball toss while walking http://goo.gl/1Ps3O

P. 490 Crunches http://goo.gl/Vq467 Standing theraband/pulley weight - Adduction http://goo.gl/lYNtO Bosu squats http://goo.gl/WAU49 Standing theraband/pulley weight - Flexion http://goo.gl/IshHg Standing theraband/pulley weight - Abduction http://goo.gl/E5CPE Standing theraband/pulley weight - Extension http://goo.gl/NvZnN

P. 491 Single leg balance - fi rm to soft surface http://goo.gl/ni9hg Sidestepping with resistance (pause on affected limb), sports cord walking forward and backward (pause on affected limb)

http://goo.gl/H7Thn

Clamshells with theraband http://goo.gl/Jgsb6 Leg press (gradually increasing weight) http://goo.gl/BCpCe

Iliopsoas Release Exercises

539Links to Video Demonstration

P. 492 Physioball hamstring exercises - hip lift, bent knee hip lift, curls, balance (top photo) http://goo.gl/sMdX3 Physioball hamstring exercises - hip lift, bent knee hip lift, curls, balance (bottom photo) http://goo.gl/lcitg Superman on physioball - 2 point on physioball http://goo.gl/p82FO

P. 493 Step-ups with eccentric lowering http://goo.gl/Oho0S Side steps over cups/hurdles (with ball toss and external sports cord resistance), increase speed http://goo.gl/vBLGc Lunges progress from single plane to tri-planar, add medicine balls for resistance and rotation http://goo.gl/syM2y Single leg body weight squats, incerase external resistance, stand on soft surface http://goo.gl/NzbKh Theraband walking patterns http://goo.gl/3ovrA

P. 494 Single leg pick-ups, add soft surface http://goo.gl/RzSrr

540 Appendix: Labral Repair Exercises

Page Exercise Link to video demonstration

P. 495 Ankle pumps http://goo.gl/ZgqKk Glut sets http://goo.gl/Eiq9M

P. 496 Quad sets http://goo.gl/cJcBG Heel slides, active-assisted range of motion http://goo.gl/txSao Hamstring sets http://goo.gl/oB8PN Log rolling internal rotation http://goo.gl/nAOjL Adductor isometrics http://goo.gl/gE9UF Pelvic tilt http://goo.gl/417CV

P. 497 Double leg bridges http://goo.gl/417CV Prone knee fl exion http://goo.gl/Iz4kH Seated knee extensions http://goo.gl/BY5ec Standing abduction without resistance http://goo.gl/0IrpB Prone on elbows http://goo.gl/LlC83 Standing adduction without resistance http://goo.gl/eyU9i

P. 498 Standing extension without resistance http://goo.gl/nzb00 Pain dominant hip mobilization, grade I http://goo.gl/pJ1OY Standing fl exion without resistance http://goo.gl/QbtFl Supine marching (90 degrees) http://goo.gl/sI4Wm Modi fi ed deadbug (90 degrees) http://goo.gl/Vy5F3

P. 499 Superman http://goo.gl/CspFC Theraband resistance on affected side - Adduction (start very low resistance) http://goo.gl/lYNtO Abduction isometrics http://goo.gl/rw3x7 Theraband resistance on affected side - Flexion (start very low resistance) http://goo.gl/IshHg Theraband resistance on affected side - Abduction (start very low resistance) http://goo.gl/E5CPE Theraband resistance on affected side - Extension (start very low resistance) http://goo.gl/NvZnN

P. 500 Leg raise - Abduction http://goo.gl/dbj0t Seated physioball progression - hip fl exion to 90 degrees http://goo.gl/rwov6 Leg raise - Extension http://goo.gl/yjNad

P. 501 Crunches http://goo.gl/Vq467 Clamshells http://goo.gl/uckKA Weight shifts - standing, sitting, supported, anterior/posterior, laterals, physioball http://goo.gl/LkxoY Leg press (minimal resistance, gradually increasing resistance to patient tolerance) http://goo.gl/BCpCe 1/4 mini squats http://goo.gl/3mf4I

P. 502 Superman (quadriped position) http://goo.gl/ExPJN Standing theraband - Flexion http://goo.gl/IshHg Standing theraband - Abduction http://goo.gl/E5CPE Standing theraband - Extension http://goo.gl/NvZnN Standing theraband - Adduction http://goo.gl/lYNtO Standing heel raises http://goo.gl/TUekm

P. 503 Single leg bridges/stabilization/alternate kickouts http://goo.gl/Xng3v Clamshells with restrictive tubing/band http://goo.gl/Jgsb6 Single leg balance - fi rm to soft surface with external perturbation (ball catch, sports speci fi c/simulated ex.)

http://goo.gl/ni9hg

P. 504 Physioball hamstring ex. - hip lift, bent knee hip lift, curls, balance (top photo) http://goo.gl/sMdX3 Physioball hamstring ex. - hip lift, bent knee hip lift, curls, balance (bottom photo) http://goo.gl/lcitg Side stepping with resistance (pause on affected limb), sports cord walking forward and backward (pause on affected limb)

http://goo.gl/H7Thn

Bosu squats http://goo.gl/WAU49 P. 505 Step-ups with eccentric lowering http://goo.gl/Oho0S

Side steps over cups/hurdles (with ball toss and external sports cord resistance), increase speed http://goo.gl/vBLGc Lunges progress from single plane to tri-planar, add medicine balls for resistance and rotation http://goo.gl/syM2y Single leg body weight squats, increase external resistance, stand on soft surface http://goo.gl/NzbKh Theraband walking patterns http://goo.gl/3ovrA

P. 506 Single leg pick-ups, add soft surface http://goo.gl/RzSrr

Labral Repair Exercises

541Links to Video Demonstration

Microfracture Exercises

Page Exercise Link to video demonstration

P. 507 Seated knee extensions http://goo.gl/BY5ec Ankle pumps http://goo.gl/QcQ3L

P. 508 Glut sets http://goo.gl/pr1AM Adductor isometrics http://goo.gl/gE9UF Quad sets http://goo.gl/cJcBG Heel slides, active-assisted range of motion http://goo.gl/txSao Hamstring sets http://goo.gl/oB8PN Log rolling http://goo.gl/nAOjL

P. 509 Pelvic tilt http://goo.gl/Fl9Yh Prone on elbows http://goo.gl/LlC83 Trunk rotation http://goo.gl/nO9ob Prone knee fl exion http://goo.gl/Iz4kH Double leg bridges http://goo.gl/Fl9Yh Standing abduction without resistance http://goo.gl/WDm5n

P. 510 Standing adduction without resistance http://goo.gl/Yjq9S Standing fl exion without resistance http://goo.gl/ZoPKO Standing extension without resistance http://goo.gl/nzb00 Pain dominant hip mobilization, grades I, II http://goo.gl/pJ1OY

P. 511 Supine marching, modi fi ed dead bug http://goo.gl/Vy5F3 Theraband resistance on affected side - Abduction (start very low resistance) http://goo.gl/E5CPE Superman http://goo.gl/CspFC Theraband resistance on affected side - Adduction (start very low resistance) http://goo.gl/lYNtO Abduction isometrics http://goo.gl/rw3x7 Theraband resistance on affected side - Flexion (start very low resistance) http://goo.gl/IshHg

P. 512 Theraband resistance on affected side - Extension (start very low resistance) http://goo.gl/NvZnN Hip fl exion, IR/ER in pain-free range http://goo.gl/wdnUS Leg raise - Abduction http://goo.gl/dbj0t Clamshells http://goo.gl/uckKA Leg raise - Extension http://goo.gl/yjNad

P. 513 Seated physioball progression - active hip/knee http://goo.gl/rwov6 Theraband resistance on affected side - Abduction (start very low resistance) http://goo.gl/E5CPE Theraband resistance on affected side - Adduction (start very low resistance) http://goo.gl/lYNtO

P. 514 Theraband resistance on affected side - Flexion (start very low resistance) http://goo.gl/IshHg Crunches http://goo.gl/Vq467 Theraband resistance on affected side - Extension (start very low resistance) http://goo.gl/NvZnN

P. 515 Superman (quadriped position) http://goo.gl/ExPJN Clamshells with resistive tubing/band http://goo.gl/Jgsb6 1/4 mini squats http://goo.gl/3mf4I Standing heel lifts http://goo.gl/TUekm

P. 516 Single leg bridges/stabilization/alternate kickouts http://goo.gl/Xng3v Single leg balance - fi rm to soft surface with external perturbation (ball catch, sports speci fi c/simulated ex.)

http://goo.gl/ni9hg

Physioball hamstring exercises - hip lift, bent knee hip lift, curls, balance (top photo) http://goo.gl/sMdX3 Physioball hamstring exercises - hip lift, bent knee hip lift, curls, balance (bottom photo) http://goo.gl/lcitg

P. 517 Sidestepping with resistance (pause on affected limb), sports cord walking forward and backward (pause on affected limb)

http://goo.gl/H7Thn

Bosu squats http://goo.gl/WAU49 Step-ups with eccentric lowering http://goo.gl/Oho0S Lunges progress from single plane to tri-planar lunges, add medicine balls for resistance and rotation http://goo.gl/syM2y

P. 518 Theraband walking patterns http://goo.gl/3ovrA Single leg body weight squats, increase external ressistance, stand on soft surface http://goo.gl/NzbKh Side steps over cups/hurdles (with ball toss and external sports cord resistance), increase speed http://goo.gl/vBLGc

P. 519 Single leg pick-ups, add soft surface http://goo.gl/RzSrr

542 Appendix: Routine Arthroscopic Procedure Exercises

Page Exercise Link to video demonstration

P. 521 Seated weight shifts, lateral http://goo.gl/LkxoY Glut sets http://goo.gl/pr1AM Seated knee extensions http://goo.gl/BY5ec Quad sets http://goo.gl/cJcBG Ankle pumps http://goo.gl/QcQ3L Hamstring sets http://goo.gl/oB8PN

P. 522 Adductor isometrics http://goo.gl/gE9UF Pelvic tilt http://goo.gl/Fl9Yh Heel slides, active-assisted range of motion http://goo.gl/txSao Trunk rotation http://goo.gl/nO9ob Log rolling http://goo.gl/nAOjL Double leg bridges http://goo.gl/Fl9Yh

P. 523 Prone on elbows http://goo.gl/LlC83 Standing adduction without resistance http://goo.gl/Yjq9S Prone knee fl exion http://goo.gl/Iz4kH Standing extension without resistance http://goo.gl/nzb00 Standing abduction without resistance http://goo.gl/WDm5n Standing fl exion without resistance http://goo.gl/ZoPKO

P. 524 Pain dominant hip mobilization - grades I, II http://goo.gl/pJ1OY Abduction isometrics http://goo.gl/rw3x7 1/4 mini squats http://goo.gl/3mf4I Weight shifts - anterior/posterior http://goo.gl/kdRPI Standing heel lifts http://goo.gl/TUekm

P. 525 Hip fl exion, IR/ER in pain-free range http://goo.gl/wdnUS Theraband resistance on affected side - Flexion (start very low resistance) http://goo.gl/IshHg Theraband resistance on affected side - Abduction (start very low resistance) http://goo.gl/E5CPE Theraband resistance on affected side - Extension (start very low resistance) http://goo.gl/NvZnN Theraband resistance on affected side - Adduction (start very low resistance) http://goo.gl/lYNtO Superman http://goo.gl/CspFC

P. 526 Stiffness dominant hip mobilization, grades III, IV (top photo) http://goo.gl/MQEFE Stiffness dominant hip mobilization, grades III, IV (bottom photo) http://goo.gl/Br94X Double leg bridges to single leg bridges http://goo.gl/Xng3v Clamshells (pain-free range) http://goo.gl/uckKA

P. 527 Leg raise - Abduction http://goo.gl/dbj0t Dead bug http://goo.gl/Vy5F3 Leg raise - Extension http://goo.gl/yjNad Quadriped 4 point support, progress 3 point support, progress 2 point http://goo.gl/SsafD Shuttle leg press 90 degree hip fl exion with co-contraction of adductors http://goo.gl/BCpCe Seated physioball progression - hip fl exion http://goo.gl/rwov6

P. 528 Forward walking over cups and hurdles (pause on affected limb), add ball toss while walking http://goo.gl/1Ps3O Lateral walking over cups and hurdles (pause on affected limb), add ball toss while walking http://goo.gl/vBLGc

P. 529 Crunches http://goo.gl/Vq467 Standing theraband/pulley weight - Adduction http://goo.gl/lYNtO Bosu squats http://goo.gl/WAU49 Standing theraband/pulley weight - Flexion http://goo.gl/IshHg Standing theraband/pulley weight - Abduction http://goo.gl/E5CPE Standing theraband/pulley weight - Extension http://goo.gl/NvZnN

P. 530 Single leg balance - fi rm to soft surface http://goo.gl/ni9hg Side stepping with resistance (pause on affected limb), sports cord walking forward and backward (pause on affected limb)

http://goo.gl/H7Thn

Clamshells with theraband http://goo.gl/Jgsb6 Leg press (gradually increasing weight) http://goo.gl/BCpCe

Routine Arthroscopic Procedure Exercises

543Links to Video Demonstration

P. 531 Physioball hamstring exercises - hip lift, bent knee hip lift, curls, balance (top photo) http://goo.gl/sMdX3 Physioball hamstring exercises - hip lift, bent knee hip lift, curls, balance (bottom photo) http://goo.gl/lcitg Superman on physioball - 2 point on physioball http://goo.gl/p82FO

P. 532 Step-ups with eccentric lowering http://goo.gl/Oho0S Side steps over cups/hurdles (with ball toss and external sports cord resistance), increase speed http://goo.gl/vBLGc Lunges progress from single plane to tri-planar, add medicine balls for resistance and rotation http://goo.gl/syM2y Single leg body weight squats, increase external resistance, stand on soft surface http://goo.gl/NzbKh Theraband walking patterns http://goo.gl/3ovrA

P. 533 Single leg pick-ups, add soft surface http://goo.gl/RzSrr

545J.W.T. Byrd (ed.), Operative Hip Arthroscopy, DOI 10.1007/978-1-4419-7925-4, © Springer Science+Business Media New York 2013

A Abdominal compartment syndrome , 405 Abdominal Repair Rehab Program , 63 Abductor de fi ciency , 400 Abductor tendinopathies and repair

history and physical examination , 300 insertional anatomy , 299–300 magnetic resonance imaging , 300–302 natural history , 299 outcome , 307 postoperative management , 305–307 surgical technique

fl uoroscopy , 302 gluteus medius muscle , 302–304, 306 midanterior portal , 302 peritrochanteric space , 302–303 standard arthroscopic knot tying techniques , 307 standard cruciate technique , 305, 308 vastus lateralis , 303–304

ultrasound , 302 Abductor tendonopathy , 443 Absorbable sutures , 378 Acetabular fossa

acetabulum , 87, 88 contents of , 197 in fl amed pulvinar debridement , 201 ligamentum teres

anatomy and physiology , 197–198 case presentation , 200–201 clinical presentation , 198–199 treatment , 199–200

removal of loose bodies , 201–202 symptomatic hip plicae , 201

Acetabular rim , 269–270 Acetabuloplasty , 455–467 Acetabulum , 271

acetabular fossa , 87, 88 morphology of , 86, 87 synovial tissue , 88

Adhesive capsulitis arthroscopic treatment , 352–354 conservative treatment , 351–352 imaging , 351 physical examination , 349–351 postoperative rehabilitation , 354 presentation , 349 primary intrinsic capsular disorder , 354

Adolescence and childhood anatomy , 368 avascular necrosis , 372–373 complications , 371 developmental dysplasia , 367

diagnostic arthroscopy , 368 epiphyseal dysplasia , 373 FAI , 373–374 hip arthroscopy , 369–371 hip dysplasia , 372 imaging , 368–369 juvenile chronic arthritis , 367 Legg-Calve-Perthes disease , 367 loose body removal , 368 physical examination , 368 postoperative management , 371 SCFE , 367, 373 septic arthritis and trauma , 374 surgical dislocation approach , 367 synovial biopsy , 368

Adult hip imaging diagnostic imaging

aspiration and bursography , 38–40 computed tomography , 34–36 conventional magnetic resonance

imaging , 37 CT arthrography , 35, 36 hip arthrography , 38–40 injection , 38–40 magnetic resonance arthrography , 37–38 nuclear scintigraphy , 38 plain radiography , 33–35 ultrasound , 35–37

femoral neck stress fracture , 51 incomplete intertrochanteric fracture , 51 ligamentum teres pathology , 45, 46, 48 miscellaneous hip pathology

acute trauma and stress injury , 49–51 osteonecrosis , 48–49

MR arthrography , 40–42 normal intra-articular hip anatomy , 40–41 OA, FAI and labral pathology , 41–47 septic arthritis , 50, 52 snapping hip syndrome , 51, 52

AIIS . See Anterior inferior iliac spine (AIIS) Alcock canal , 325 Anesthesia , 353–354 Anterior inferior iliac spine (AIIS) , 388 Anterior portal

anterior view , 103, 104 ASIS , 142 femoral nerve , 105, 106, 138 lateral circum fl ex femoral artery , 138 lateral femoral cutaneous nerve , 104, 105, 138 LFCA , 106 right femoral triangle , 104 sartorius and rectus femoris muscles , 105

Index

546 Index

Anterolateral portal , 100 acetabular labrum and articular cartilage , 101 artery path , 101 greater trochanter , 100 superior gluteal nerve , 101, 136, 139

AP . See Athletic pubalgia (AP) Arthrex Hip Distractor System , 126 Arthro fi brosis

arthroscope cannula , 355 capsulectomy , 355 intraoperative fl uoroscopic image , 356 peripheral compartment , 355 portal placements , 355 posterolateral labrum , 355 soft tissues , 354, 355 traction , 355

Arthroscopic anatomy acetabular labrum , 113, 114 ASIS , 113 central compartment

anterior triangle , 117 iliopubic groove , 117, 118 posterior capsule and posterior acetabulum , 117 posterolateral portal , 118

intracapsular anatomy , 113 ligamentum teres , 114–115 paralabral sulcus , 114 peripheral compartment

anterolateral portal , 118 lateral femoral head and acetabular labrum , 119 peripheral labrum and anterior capsule , 119

synovial folds lateral , 115, 116 medial , 115

systematic arthroscopic exam , 116 transverse line , 113, 114

Arthroscopic surgery, hip ambulation and movement , 452 communications , 453 dressing and wound care , 452 exercise/physical therapy , 453 fi rst post-operative visit , 453 ice , 452 medications , 452–453

Athletic pubalgia (AP) , 443 adductor enthesis , 395 anatomic considerations , 55, 56 chronic groin injury , 394 differential diagnosis

acute adductor injuries , 56 chronic adductor injuries , 56 chronic groin pain , 57 inguinal fl oor , 57 inguinal hernia , 55, 56 local injection therapy , 58 MRI of pelvis , 57, 58 NHL players , 56

external oblique aponeurosis , 60, 61 FAI , 393 femoroacetabular impingement , 216 Gilmore’s groin , 393 ilioinguinal nerve , 60, 61 medial enthesopathy , 394 pathophysiologic mechanisms , 59 polypropylene mesh , 60 posterior inguinal fl oor , 60 postoperative rehabilitation and physical therapy , 62–64

PTFE , 61 recalcitrant adductor and rectus abdominis

tendonitis , 395 sports hernia

clinical considerations , 73–74 core , 68–70 diagnosis , 71–73 muscles , 69 pathophysiology , 70–72 rehabilitation , 75 reoperation , 76 results , 75–76 return to play data , 75–76 treatment , 74–75

surgical indications , 59, 60 surgical outcomes , 61, 62 syndromes and procedures , 75 tension-free mesh approaches , 61 total extraperitoneal approach , 61

Avascular necrosis , 372–373, 405 Avascular necrosis (AVN) , 187 Axial traction apprehension test , 239, 240

B Barlow sign , 342 Bilateral osteonecrosis , 48

C Calcium pyrophosphate deposition (CPPD) , 208 CAM lesion , 407 Capsulotomy , 405

anterior view , 92 peripheral portal

anterior and anterolateral portals , 148, 151, 152 iliopsoas tendon , 1529 posterolateral portal , 150, 151 proximal and distal anterolateral portals , 151, 152

Cartilage injury , 405–406 Chondral fl aps , 370 Chondral injuries

anatomy , 185 contraindications , 189 history , 187 imaging , 188 indications , 188–189 inspection , 190 management techniques , 190–195 outcomes , 195–196 pathomechanics

labrochondral disruption , 185–186 traumatic subluxation/dislocation , 186–187 wave sign/carpet delamination , 186

patient positioning , 189–190 physical examination , 187–188 portal placement , 190 postoperative rehabilitation , 195 surgical technique , 189 traumatic , 185

Chondrocalcinosis , 208, 210–211 Clamshell progression , 427, 428 Compensatory disorders, hip

anterior enthesopathy AIIS subspine impingement , 390–391 athletic pubalgia , 393–395 hip fl exor strain , 388

547Index

iliopsoas impingement , 388–390 medial enthesopathy , 391 osteitis pubis , 391–393

bony posterior compensatory patterns lumbar spine , 398 posterior hip subluxation and FAI , 398–400 SI joint , 397–398

deep gluteal syndrome , 386 enthesopathies and tendinopathies , 386 hemipelvis , 386 lateral enthesopathy , 400 layered approach , 385 neurokinetic layer , 386 posterior compensatory patterns , 395–397 structural mechanics , 385

Complex hip reconstruction capsular reconstruction

iliofemoral ligament , 381 ischiofemoral ligament , 381 rehabilitation , 382 technique , 381–382

clinical results , 378–379 iliotibial band labral reconstruction , 377 ligamentum teres reconstruction

clinical results , 381 debridement , 379 degenerative changes , 379 femoroacetabular impingement , 380 open surgical dislocations , 379 radiologic diagnosis , 379 technique , 380–381 vascular supply , 379

technique , 377–378 Computed tomography (CT) , 369

femoroacetabular impingement , 217 removal of loose body , 162

Computer-assisted surgery femoroacetabular impingement

anatomic factors , 251 combined model , 257, 259 computer software system , 257, 260, 261 desired correction , 257, 258 equidistant method , 253 extra-articular impingement , 257, 260 femoral-sided correction , 257, 258 high-resolution computed tomography scan , 255 HipMotion software , 252, 256 linkage encoders , 252–253 pathoanatomy , 250–251 preoperative CT scans , 251 preoperative 3D imaging data , 253 simple and constrained method , 254 templating software , 257, 259 theoretical goals , 251 three-dimensional models , 254, 256, 257 translated and equidistant method , 254

orthopedics , 249–250 Continuous passive motion (CPM) machine , 371 Cortisone injection , 352 Coxa profunda , 370 CPPD . See Calcium pyrophosphate

deposition (CPPD) Crossover sign , 341 Crutch/gait training , 423 Cryotherapy , 450 C sign , 414 Cysts , 272–274

D Deep gluteal syndrome , 386 Degenerative joint disease (DJD) , 163–165, 345 Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) , 369 Diagnostic arthroscopy

acetabular fossa , 145 anterior portal , 145 anterolateral portal , 144 iliopsoas tendon , 146 labral cleft , 146, 147 lateral labrum , 143, 144 physeal scar , 147 posterior labrum , 145 posterolateral portal , 145 stellate crease , 147 supra-acetabular fossa , 148 transverse capsulotomy , 146

Distal lateral accessory portal (DLAP) , 390 DLAP . See Distal lateral accessory portal (DLAP) Dysplasia , 185

E Endoscopic hamstring repair and ischial bursectomy

anatomy , 331–332 clinical examination and imaging , 333–334 endoscopic technique

arthroscopic rotator cuff repair , 336 devitalized tissue , 336 gluteus maximus muscle , 335 medial portal , 335 physical therapy , 337 prone position , 335 sciatic nerve , 335 soft tissue bands , 336 suture anchors , 336 weight bearing , 337

injury mechanism , 332–333 musculotendinous junction , 331 partial avulsions , 331 treatment , 334–335

Epiphyseal dysplasia , 373 Erectile dysfunction (ED) , 404 Euthermia , 294 External rotation dial test , 239, 240 External snapping hip syndrome , 297, 298 Extra-articular disorders , 444

F FADIR . See Flexion-adduction-internal rotation (FADIR) FAI . See Femoroacetabular impingement (FAI) Falciform process , 325 Falciform process (FP) , 313 Fatigue , 451 Femoral head

fovea capitis , 85, 86 inferior gemellus muscles , 86, 87 MFCA , 85, 86 pelvitrochanteric muscles , 87 posterior region , 86, 87 quadratus femoris , 86, 87

Femoroacetabular impingement overresection

femoral neck fracture , 406 instability , 406–407

underresection , 406

548 Index

Femoroacetabular impingement (FAI) , 443 arthroscopic procedure

abnormal bone , 231 acetabular rim , 222 anchor placement , 223 anterior portal site , 220 anterolateral portal , 229 articular surface , 228 bone debris , 230 bony impingement , 230–231 cam impingement , 224 capsulotomy , 225 cephalad anterolateral portal , 228 chondrolabral junction , 223 curved drill guide system , 222 3D CT scans , 230 distal portal , 228 3D MRI , 230 fl uoroscopy , 222–223, 231 heterotopic ossi fi cation , 230 iatrogenic instability , 218 intra-articular damage , 217 labral degeneration , 219 lateral synovial fold , 228 mattress suture , 226 percutaneous delivery system , 222 pincer lesion , 218 portal placement , 217, 220 selective debridement , 221 soft tissue preparation , 228 suture anchors , 222 tissue-penetrating device , 223

cam impingement , 216 capsular laxity tests , 239, 240 clinical presentations , 237–238 computer-assisted surgery

anatomic factors , 251 combined model , 257, 259 computer software system , 257, 260, 261 desired correction , 257, 258 equidistant method , 253 extra-articular impingement , 257, 260 femoral-sided correction , 257, 258 high-resolution computed tomography scan , 255 HipMotion software , 252, 256 linkage encoders , 252–253 pathoanatomy , 250–251 preoperative CT scans , 251 preoperative 3D imaging data , 253 simple and constrained method , 254 templating software , 257, 259 theoretical goals , 251 three-dimensional models , 254, 256, 257 translated and equidistant method , 254

FABER test , 239 imaging , 216–219 impingement signs , 239 labral pathology , 44 magnetic resonance imaging , 242 MR arthrography , 45 osteoarthritis , 215 pain test , 240 patient evaluation , 216, 217 physical examination , 238–239 pincer FAI , 43

pincer impingement , 215 plain radiograph , 41 plain radiographs , 240–241 post-op rehabilitation , 231 psoas irritation , 240, 241 rehabilitation , 246–247 results , 231, 234, 247 slipped capital femoral epiphysis , 215 surgical technique

portal placement , 243–247 surgical setup and traction , 242–244

Femoroplasty , 468–480 Flexion-adduction-internal rotation (FADIR) , 389 Foreign bodies , 167 Freiberg sign , 397

G Gadolinium arthrography , 351 Gait cycle , 415 Gluteus medius muscle , 423 Greater trochanter (GT) , 292 Greater trochanteric pain syndrome (GTPS) , 299 Gross anatomy

central compartment acetabular labrum , 89 acetabulum , 86–88 femoral head , 85–87 ligamentum teres , 88–89

peripheral compartment capsule , 90, 91 femoral neck , 89–90 synovial , 90–92

peritrochanteric space deep gluteal region , 92–94 hip bursae complex , 92 iliopsoas tendon , 95–96 proximal femur , 91, 92

H Ischial Tunnel syndrome , 314 Heterotopic ossi fi cation (HO) , 153, 154, 407 Hip arthroscopy

arthroscopic procedure , 2 arthroscopic visualization , 1 avascular necrosis , 405 Burman’s illustration , 2 cartilage injury , 405–406 central compartment

anterior portal , 136, 138 anterolateral portal , 136, 139 diagnostic arthroscopy , 142–148 fl uoroscopic image , 143 neurovascular structures , 138 portal placement , 137, 139, 140 posterolateral portal , 137, 139 standard portals , 136, 138

children and adolescents , 407–408 clinical implications of , 3 equipment

cannulated obturator system , 134, 135 extra-length cannulas , 134, 135 radiofrequency device , 136 scrub nurse’s Mayo stand , 135

549Index

slotted cannulas , 135 standard arthroscopic cannula , 135

femoroacetabular impingement overresection , 406–407 underresection , 406

fl uid management , 404–405 general complications , 403–404 heterotopic ossi fi cation , 407 iliopsoas bursoscopy

heterotopic ossi fi cation , 153, 154 left hip AP radiograph , 154 lesser trochanter , 153, 154

learning curve , 408 operating room setup

anesthesia , 131 patient positioning , 131–134 perineal post , 132 standard OR table , 131, 132 transverse component , 133

overview and history , 1–5 peripheral compartment

capsulotomy , 150–153 portal placement , 148–152

peritrochanteric space distal portal , 155 fl uoroscopic image , 155 gluteus medium , 155 greater trochanter , 154, 157 iliotibial band , 155, 156

position and distraction options ( see Position and distraction options) subgluteal space , 155, 158, 159 surgical reconstruction , 4 technique , 136 traction , 404 traction neurapraxias , 133

Hip fl exor strain , 388 Hip instability

anatomy acetabular labrum , 339 capsuloligamentous complex , 339 iliofemoral ligament , 339 ischiofemoral ligament , 340 pubofemoral ligament , 339–340 screw home effect , 340 zona orbicularis , 340

atraumatic instability anterior capsular laxity , 343 Barlow and Ortolani signs , 342 congenital connective tissue disorders , 342 Down’s syndrome , 342 Ehlers-Danlos syndrome , 342 femoral osteotomies , 344 Marfan’s syndrome , 342 NSAIDS , 343 PAO , 344 pelvic reconstructive osteotomies , 344 plication , 342 snaping hip syndrome , 342 surgical intervention , 343 thermal capsulorrhaphy , 343 tissue shrinkage , 342

clinical evaluation age , 340 antalgic gait patterns , 340 AP pelvis radiograph , 341

bony lesions , 341 CT arthrography , 341 MRI arthrography , 341 suction seal effect , 340 Tonnis angle , 340

traumatic instability armamentarium , 345 AVN , 345, 346 capsular disruption , 344 dashboard motor vehicle injury , 344 DJD , 345 labral tear , 344 TE injuries , 345

Hip luxation protocol , 482–494 HipMotion software , 252, 256 Hip pain

extra-articular symptoms , 442 intra-articular symptoms , 442

Hip rehabilitation advanced exercise and neuromotor control , 431 assessment and overview

acetabular labral tear , 413 “C” sign , 413 FAI , 412 joint dysfunction , 412 pain-free functional movement , 412 presurgical treatment , 411

conservative treatment athlete’s training program , 420 avoid long term activities , 419 comprehensive programs , 420 education , 419 lumbopelvic (core) stabilization , 420 manual therapy , 420 normal squatting position , 420

history , 413 initial visit , 422 intermediate exercise and stabilization

arthrokinetic inhibition , 428 core stability , 429 double leg bridge , 429 lumbopelvic-hip musculature complex , 431 mini-squat , 429 prone heel squeezes , 430 range of motion exercises , 428 reciprocal inhibition , 428 resisted hip extension , 430 side-lying hip abduction , 430 single leg bridge , 429 stool hip internal/external rotation , 429 strengthening and stabilization exercises , 429 synergistic dominance , 428

loaded and unloaded implications , 419 mobility and initial exercise , 423 mobilizations

clamshell progression , 427 Cyriax , 426 distraction techniques , 424 exercise selection , 426 external rotation , 425 gait activities , 427 gluteal isometrics , 427 iliopsoas activation , 427 inferior/caudal glide mobilization , 424 internal rotation , 425

550 Index

Hip rehabilitation ( cont. ) longitudinal hip distraction , 424 maximum volitional contraction , 427 ROM restrictions , 425 side-lying hip extension posterior-anterior , 425 single leg squat criterion , 426

movement dysfunction and assessment , 416 physical examination , 413–415 return to activity , 433 selective functional movement assessment

exercise , 416 low back dysfunction , 416 mobility and stability , 416 movement patterns , 416 musculoskeletal system , 416 scoring system , 416–419

treatment/rehabilitation progression , 421–422 HO . See Heterotopic ossi fi cation (HO)

I Iliopsoas (ILP) , 446 Iliopsoas bursoscopy

heterotopic ossi fi cation , 153, 154 left hip AP radiograph , 164 lesser trochanter , 153, 154

Iliopsoas impingement (IPI) clinical presentation , 389 DLAP , 390 FADIR , 389 labral tear , 388 mechanical symptoms , 389 physical therapy , 390 THA , 388

Iliopsoas release , 482–493 Iliopsoas tendon release

central compartment release , 283, 284 hip periphery , 283–286 iliopsoas bursa , 284, 286–288 iliopsoas impingement , 281–282 iliopsoas tendinitis , 279 internal snapping hip syndrome

iliopectineal eminence , 279, 280 imaging of , 280, 281 physical examination of , 280–281

results of , 287–289 Iliotibial band release

contraindications , 294 coxa saltans externa , 292 endoscopic technique , 294–297 external snapping hip syndrome , 297, 298 indication, surgery , 292–294 lateral hip anatomy , 291–292 pathomechnanics , 291–292 physical examination , 292 postoperative management , 297

Impingement test , 443 Inferior trochanteric portal , 295 Internal snapping hip syndrome

iliopectineal eminence , 279, 280 imaging of , 280, 281 physical examination of , 280–281

International Society for Hip Arthroscopy (ISHA) , 5 Intra-articular hip pathology , 442 IPI . See Iliopsoas impingement (IPI) Ischial tuberosity , 331

Ischiofemoral impingement syndrome , 326 Isokinetic testing , 334 ITB syndrome , 400

L Labral de fi ciency , 378 Labral repair , 495–506 Labrum

anatomy acetabulum and fi brocartilaginous labrum , 172 capsulolabral re fl ection , 171 hip labrum, zones of , 173 normal cleft , 171, 174 pathological tear , 171, 172 vascular injection studies , 171

debridement techniques , 175–176 function , 173, 175 management algorithm , 173–175 reconstruction , 179–183 repair technique , 176–183

Laségue sign , 395 Lateral enthesopathy , 400 Lateral femoral circum fl ex artery (LFCA) , 86, 106 Lateral femoral cutaneous (LFC) , 404 Lateral impact syndrome , 185, 187 LCPD . See Legg-Calve-Perthes disease (LCPD) Leg extension test , 431 Legg-Calve-Perthes disease (LCPD) ,

164–166, 367, 372 LFCA . See Lateral femoral circum fl ex

artery (LFCA) Ligamentum teres , 88–89

anatomy and physiology , 197–198 case presentation , 200–201 clinical presentation , 198–199 reconstruction

clinical results , 381 debridement , 379 degenerative changes , 379 femoroacetabular impingement , 380 open surgical dislocations , 379 radiologic diagnosis , 379 technique , 380–381 vascular supply , 379

treatment , 199–200 Loose bodies

acetabular fossa , 201–202 calcium deposit, labral tears , 167 classi fi cation of , 161 degenerative joint disease , 163–165 device types , 168 diagnosis , 161 foreign bodies , 167 imaging , 161–162 osacetabuli , 165–167 osteoarthritis , 275–276 vs. osteochondral bodies , 161 osteochondritis dissecans , 164–166 posttraumatic

acetabular rim fracture , 162 femoral head fracture , 162–163

signs and symptoms , 161 synovial chondromatosis , 163, 164

Lumbar spine , 398 Lumbosacral plexus , 413

551Index

M Magnetic resonance arthrography (MRA) , 37–38

chondral injuries , 188 internal snapping hip syndrome , 281 removal of loose body , 162

Magnetic resonance imaging (MRI) , 367, 369 chondral injuries , 188 femoroacetabular impingement , 218, 242

Medial femoral circum fl ex artery (MFCA) , 85, 86 Metaplasia , 208 Microfracture , 190–195, 507–519 Mild osteoarthritis , 264 MRA . See Magnetic resonance arthrography (MRA) MRI . See Magnetic resonance imaging (MRI)

N Non-arthritic hip score (NAHS) , 167 Nonsteroidal anti-in fl ammatory drugs (NSAIDs) , 81

O OA . See Osteoarthritis (OA) Ober test , 293 Obturator internus (OI) , 312 Orthopedics , 249–250 Ortolani sign , 342 Os acetabuli , 165–167 Osteitis pubis

athletes , 391 local steroid injections , 393 MRI , 391 nonoperative treatment , 393

Osteoarthritis (OA) acetabular rim , 269–270 acetabulum , 271 capsule , 276 correlation of , 264 cysts , 272–274 degeneration curve , 277 good candidates , 264 head , 272–273 head-neck junction and femur neck , 271–272 intra-articular and extra-articular fi ndings , 266 labral reconstruction , 274–275 loose bodies , 275–276 MR arthrography , 47 notch , 271–272 pathology , 265–266 patient selection , 264 poor candidate , 264–265 postoperative care and rehabilitation ,

276–277 preoperative fl uoroscopy , 267–268 primary , 41 retrospective study , 264 secondary , 41 signs and symptoms , 264 surgical plan , 268–269 synovitis , 275–276 technique , 266–267 watershed lesion , 263

Osteochondral autograft transplantation (OATS) , 195

Osteochondritis dissecans (OCD) , 164–166 Osteonecrosis , 46, 48–49

P Pace sign , 395 Palpation , 443 PAO . See Periacetabular osteotomy (PAO) Patient interview , 442 Patient selection

history , 8 inspection , 8–11 measurements

abduction and adduction , 12 leg lengths , 11 prone position , 12 rotational motion , 12 supine position , 12 thigh circumference , 11 Thomas test , 12

physical examination , 8, 9 radiology , 26–29 special tests

abduction with external rotation , 21, 22 anterior capsular laxity , 22, 23 Dial test , 23 elicit joint symptoms , 21, 26 examination features , 24 extension with internal rotation , 23, 25 forced fl exion , 16, 21 hip fl exor soreness , 25 iliopsoas tendon , 25 iliotibial band , 24, 26 lateral decubitus position , 18, 27 logroll test , 16, 21 Patrick/Faber test , 21, 23 piriformis syndrome , 24, 28 posterior impingement symptoms , 21, 22 straight leg raise test , 21, 23

symptom localization C sign , 15 one fi nger rule , 13–15 palpation , 15–20

Pelvic osteotomy , 344 Pelvic rotation test , 431 Pelvic tilt test , 429 Periacetabular osteotomy (PAO) , 215, 344 Perioperative care

activity level , 451 clinical nurse and physician extender , 441 direct patient interaction , 441 health history , 442 objective data

diagnostic testing , 443–444 physical examination , 442–443

pain control ankle soreness , 447 fascia iliacus , 449 femoral blocks , 449 heterotopic ossi fi cation , 450 muscular soreness , 447 narcotics , 449 piriformis , 449 postoperative pain , 446

patient preparation , 441 postoperative care , 445–446 postoperative instructions , 452–453 subjective data , 442 ultrasonography , 444–445 wound care , 450

552 Index

Peritrochanteric space , 321 Physical therapy , 451–453 Pigmented villonodular synovitis (PVNS) , 208–210 Pincer lesion , 406 Piriformis muscle syndrome , 313 Plain radiography , 368

cam impingement , 34 femoroacetabular impingement , 240–241 mixed impingement , 34 pincer impingement , 35

Polytetra fl uoroethylene (PTFE) , 59, 61 Portal anatomy

central compartment anterior portal , 103–107 anterolateral portal , 99–101 mid-anterior portal , 107, 108 mid-anterolateral portal , 107 posterolateral portal , 101–103

peripheral compartment ancillary/accessory anterolateral portal , 108 anterolateral portal placement , 108 mid-anterior portal , 109 posterolateral portal , 109 speci fi c portals , 108 standard portals , 108 superolateral portal , 108, 109

peritrochanteric space auxiliary posterolateral portal , 111 distal anterolateral accessory portal , 110 distal posterior portal , 111 lateral view , 110 peritrochanteric space portal , 110 proximal anterolateral accessory portal , 110 speci fi c portals , 110

structures , 100 Portal placement

cannula/obturator assembly , 140 distraction , 139 greater trochanter , 137, 139 iliopsoas tendon , 148, 151 neutral rotation , 141 nitinol guide wire , 140 peripheral compartment , 148, 149

anterior capsule , 148, 149 cannula obturator assembly , 148, 149 fl uoroscopic control , 148, 149

posterior labrum , 141 vacuum effect , 137, 140

Position and distraction options anesthesia planning , 121–122 Arthrex Hip Distractor System , 126 cannula systems , 122 complications , 127–130 Dahners Hip Distractor , 127 DR Medical Hip Distractor , 126 fl uid management , 122 fl uoroscopic imaging , 122 operating room equipment , 122 patient positioning

lateral , 124–125 supine , 122

preoperative planning , 121 radiofrequency devices , 122 Smith and Nephew Endoscopy Hip Positioning System , 126 standard table

lateral positioning , 125, 126 supine positioning , 123–124

traction , 124 tractionless hip arthroscopy , 127

Posterolateral portal , 101 gluteus minimus and piriformis muscles , 103 greater trochanter , 101, 102 medial circum fl ex artery , 102 patient positioning , 102, 103 right gluteal region , 102 sciatic nerve , 137, 141 superior gluteal nerve , 139

Primary synovial lesions , 208 Proximal femur

anterior facet , 91 greater trochanter , 91, 92 lateral facet , 92 posterior facet , 92 superoposterior facet , 91

Proximal hamstring syndrome , 395 Psoas tenotomy , 405 PTFE . See Polytetra fl uoroethylene (PTFE) Pubic symphysis , 391 Pudendal neuralgia , 325 PVNS . See Pigmented villonodular synovitis (PVNS)

Q Quadratus femoris muscle , 326

R Radiographs , 351 Radionuclide scans , 351 Range of motion (ROM) , 424 Recalcitrant adhesive capsulitis , 352

S Sacroiliac joint , 412 Sacrotuberous ligament (STL) , 312 Sciatic nerve , 331 Sepsis , 211–213 Septic arthritis and trauma , 374 Short tau inversion recovery (STIR) , 48, 49 Slipped capital femoral epiphysis (SCFE) , 367, 373 Smith and Nephew Endoscopy Hip Positioning System , 126 Snapping hip syndrome , 51, 52 Sports hernia

clinical considerations , 73–74 core

bony anatomy , 68 pubic anatomy , 68–69

diagnosis , 71–73 muscles , 69 pathophysiology , 70–72 rehabilitation , 75 reoperation , 76 results , 75–76 return to play data , 75–76 treatment , 74–75

Sportsmen’s groin diagnosis , 79 dynamic ultrasonography , 80 medical history , 80 Minimal Repair technique

advantages of , 82 aim of , 80 internal oblique muscle , 81

553Index

NSAIDs , 81 pain release, and exercise , 81 postoperative day , 81 rectus abdominis muscle , 80

pathophysiology , 79 physical examination , 80 posterior inguinal wall , 79

Stationary bicycling , 424 Stinch fi eld test , 240 STIR . See Short tau inversion recovery (STIR) STL . See Sacrotuberous ligament (STL) Subgluteal space and associated disorders

anatomy and biomechanics bony morphometry alterations , 313 inferior gluteal artery , 312 ischial spine , 312 medial femoral circum fl ex artery , 312 musculature , 310 nerve anatomy , 311 obturator/gemelli complex , 309 piriformis muscle , 309 pudendal nerve , 312 sciatic notch , 311 semitendinosis/biceps femoris , 309 STL , 312 superior gluteal artery , 311

ischiofemoral impingement , 326–327 operative treatment

anatomy , 325 diagnostic criteria , 325 endoscopic release , 320–325 open transgluteal approach , 320 outcomes , 326 pudendal nerve , 324–325 surgical repair , 320

physical examination and ancillary testing active contraction tests , 317 double injection technique , 318 EMG and nerve conduction studies , 319 Freiberg sign , 317 H-re fl ex , 319 MR neurography , 319 passive stretching tests , 317 seated palpation test , 318 sit pain , 317

sciatic nerve entrapment cadaveric studies characteristics , 315 deep gluteal syndrome , 313 etiologies of , 313 fi brovascular scar bands , 314 hamstring tendon insertion , 314 nonoperative treatment , 319–320 obturator internus , 316 piriformis muscle , 317 superior gluteal artery , 318 trochanteric bursae hypertrophy , 314

Superior trochanteric portal , 295

Synovectomy , 208 Synovial chondromatosis , 201–208, 352

arthroscopic view of , 164 stages of , 163

Synovial disease nonspeci fi c in fl ammatory disorders , 208 pigmented villonodular synovitis , 208–210 soft tissue tumors, classi fi cation of , 203 synovial chondromatosis , 203–210

Synovitis , 275–276

T Thompson-Epstein (TE) injuries , 345 Tonnis angle , 340 Torso rotation test , 431 Total hip arthroplasty

femoroplasty , 359 painful iliopsoas tendon

blind injection , 362 hemorrhagic iliopsoas bursitis , 362 lesser trochanter , 365 low-dose radiation treatment , 365 plain radiographs , 362 postsurgical heterotopic ossi fi cation , 365 prophylaxi , 365 tendinous insertion , 362 weight-bearing pain , 362

residual deformity , 359 resurfacing arthroplasty , 362 techniques

arthroscope cannula , 359 dense tissue , 360 positioning , 359 prosthesis , 362 soft tissue debridement , 360 traction , 359

tissue cultures , 359 Total joint replacement (THR) , 263 Traction , 404 Transducer , 444 Transient synovitis , 368 Trendelenburg gait , 412 Trochanteric bursectomy , 378 Trochanteric bursitis , 443 Trochanteric bursoscopy , 153–156 Tumors , 203

U Ultrasonography , 281 Ultrasound , 35–37, 52

W Waterskiing , 332 Weight-bearing guidelines , 422