The Lateral Approach

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The last decade has seen an evolution in the understanding of the benefits of hip arthroscopy. The technique for lateral positioning was pioneered by Dr James Glick, who became frustrated with difficulties in visualization and instrumentation, particularly in the posterior aspects of the hip joint, using the supine position and anterolateral portal placements.1 Indeed, he experienced several cases in which loose bodies could not be removed from the posterior inferior aspect of the hip joint via the supine approach.

Since the introduction of the lateral approach, this surgical approach has gained widespread acceptance by arthro-scopists.1-6 It allows a direct lateral approach to the hip joint, provides reproducible bony landmarks for orientation, and facilitates access and instrumentation of most areas within the hip joint.7

The indications for hip arthroscopy via the lateral approach are essentially the same as those via the supine approach and include synovitis, septic arthritis, removal of loose bodies, management of labral pathology, and synovial lesions. Relative indications for the lateral approach in preference to the supine approach include anterior labral pathology, posterior loose bodies, and obesity.

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