Stepwise Safe Access in Hip Arthroscopy in the Supine Position

Tips and Pearls From A to Z

David R. Maldonado, MD; Philip J. Rosinsky, MD; Jacob Shapira, MD; Benjamin G. Domb, MD


J Am Acad Orthop Surg. 2020;28(16):651-659. 

In This Article

Posterolateral Portal

In the authors' hands, the posterolateral portal is used particularly for labral reconstruction and for the treatment of pertrochanteric pathologies, such as gluteus medius tears. This portal is placed 3 to 4 cm posterior and in line with the anterolateral portal (Figure 4). Although the sciatic nerve is potentially at risk during the use of this portal, this remains a relatively safe portal. Thorey et al[31] reported a mean distance of 3.5 cm from the posterolateral portal to the sciatic nerve.

Key Points and Pearls

  1. Avoid using the spinal needle in multiple directions; this may increase the risk of neurovascular injury. Fluoroscopy is a valid tool for assessing the trajectory of hardware introducing through this portal.