Renato Locks, M. D. , Jorge Chahla, M. D. , Justin J. Mitchell, M. D

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Dynamic Hip Examination for Assessment of Impingement During Hip Arthroscopy Renato Locks, M.D., Jorge Chahla, M.D., Justin J. Mitchell, M.D., Eduardo Soares, M.D., Marc J. Philippon, M.D. Arthroscopy Techniques Volume 5, Issue 6, Pages e1367-e1372 (December 2016) DOI: 10.1016/j.eats.2016.08.011 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Right hip with the patient in the supine position illustrating the 2 standard portals for hip arthroscopy. (ALP, anterolateral portal; ASIS, anterosuperior iliac spine; MAP, midanterior portal.) Arthroscopy Techniques 2016 5, e1367-e1372DOI: (10.1016/j.eats.2016.08.011) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Patient in the supine position with the right hip in around 70°-80° of flexion, neutral abduction and rotation. At this moment, the hip starts to lose the suction seal as a result of mixed-type impingement as seen in the arthroscopic view with the camera in the midanterior portal. (C, capsule; HN, head-neck junction; L, labrum.) Arthroscopy Techniques 2016 5, e1367-e1372DOI: (10.1016/j.eats.2016.08.011) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Patient positioned supine in the traction table and arthroscopic view from the midanterior portal of the abduction test at 0° of flexion in a right hip to evaluate possible superolateral impingement. (C, capsule; HN, head-neck junction; L, labrum.) Arthroscopy Techniques 2016 5, e1367-e1372DOI: (10.1016/j.eats.2016.08.011) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Anterior impingement test in the right hip with the respective arthroscopic view from the midanterior portal showing the abutment of the head-neck junction against the acetabulum. (AIT, anterior impingement test; C, capsule; HN, head-neck junction; L, labrum.) Arthroscopy Techniques 2016 5, e1367-e1372DOI: (10.1016/j.eats.2016.08.011) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 After the labral repair and femoral osteoplasty, the initial dynamic test is repeated seeking for reminiscent impingement. Figure shows the right hip at 90° of flexion in neutral abduction and rotation and the arthroscopic view from the midanterior portal showing proper reshaping without suction seal loss. (C, capsule; HN, head-neck junction; L, labrum.) Arthroscopy Techniques 2016 5, e1367-e1372DOI: (10.1016/j.eats.2016.08.011) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 Patient positioned supine on the traction table. Figure shows the repetition of anterior impingement test on the right hip with the respective arthroscopic view from the midanterior portal after the labral repair and femoral osteoplasty, showing the absence of abutment of the head-neck junction against the acetabulum. (AIT, anterior impingement test; C, capsule; HN, head-neck junction; L, labrum.) Arthroscopy Techniques 2016 5, e1367-e1372DOI: (10.1016/j.eats.2016.08.011) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions