Forget the Greater Trochanter! Hip Joint Access With the 12 O'clock Portal in Hip Arthroscopy
Authors: Maldonado DR, Chen JW, Walker-Santiago R, Rosinsky PJ, Shapira J, Lall AC, Domb BG
DOI: 10.1016/j.eats.2019.01.017
Background
- The greater trochanter is a traditional landmark for establishing the anterolateral portal in hip arthroscopy but has limitations related to variability and risk of complications.
- This study proposes using the anterosuperior iliac spine (ASIS) as a more reliable landmark for establishing the 12 o’clock portal.
Methods
Detailed description of the 12 o’clock portal technique using ASIS as a reference, incorporating fluoroscopic guidance and palpation.
Key Findings
- The 12 o’clock portal provides more consistent and accurate hip joint access.
- It reduces complications associated with traditional portal placement near the greater trochanter.
Conclusions
The 12 o’clock portal is a safer, reproducible alternative for hip arthroscopy joint access, improving procedural precision.
What Does This Mean for Providers?
- Using the ASIS landmark for the 12 o’clock portal can increase portal placement accuracy and reduce iatrogenic injury.
- Providers should consider adopting this technique to enhance surgical safety and reproducibility in hip arthroscopy.
- Proper training and fluoroscopic guidance are essential to optimize this approach.