Postless Hip Arthroscopy for Labrum Reconstruction and Labrum Augmentation

Fig 1. Bilateral femoroacetabular impingement syndrome with an irreparable right labral tear. Anteroposterior (AP) view of the pelvis (right), Dunn view at 45° (upper right), and frog-leg view (lower right) of both hips are shown.

Fig 2. Hip arthroscopy with a postless technique. A standard operating room table with the attached hip distractor with no post (left) is shown. Proper hip distraction in the fluoroscopic image (center) and the arthroscopic view with the prepared acetabular rim post labral resection (right picture) are shown.

Fig 3. Hip arthroscopy is demonstrated in the modified supine position. The yoga mat is placed under the patient’s body to obtain distraction. There is no post placed in the groin of the patient (upper left). Hip arthroscopy portals (red dots) are marked on the right hip: ALP (anterolateral portal), MA (midanterior portal), PSP (peritrochanteric space portal), and the PP (posterior portal). There is no Trendelenburg position used to obtain hip distraction.

Fig 4. Tubularized 10-cm anterior tibialis allograft at the back table prepared meticulously with Dr. Brian White’s technique.

Fig 5. Complete instrumentation for a labrum reconstruction with a postless technique.

Fig 6. Left hip arthroscopy in the modified supine position without a post. The suture anchors are placed in the acetabular rim and exit the joint through the portals (left) and the tubularized allograft slides through the hip cannula toward the hip joint (right).

Fig 7. Complete labrum reconstruction of the hip with a postless technique and with a tubularized anterior tibialis allograft observed in the arthroscopic monitor. The achieved distraction and the smooth placement of the tubularized graft on the prepared acetabular rim are shown. Anatomic hip structures marked capsule (C), femoral head (FH), acetabulum (A), and acetabular rim (AR).