Diagnostic Procedure

After applying traction, a spinal needle is placed from the anterolateral position, and the joint is distended with fluid. The anterolateral portal is then established under fluoroscopic control for introduction of the arthroscope (Fig. 5). Careful attention is necessary to avoid perforating the labrum or scuffing the articular surface [10]. Using the 70° scope, the anterior and posterolateral portals are then placed under direct arthroscopic view, as well as under fluoroscopy for precise

Fig. 4. The relationship of the major neurovascular structures to the three standard portals is demonstrated. The femoral artery and nerve lie well medial to the anterior portal. The sciatic nerve lies posterior to the posterolateral portal. Small branches of the lateral femoral cutaneous nerve lie close to the anterior portal. Injury to these is avoided by using proper technique in portal placement. The anterolateral portal is established first, as it lies most centrally in the safe zone for arthroscopy. (Courtesy of J.W. Thomas Byrd, MD.)

Fig. 4. The relationship of the major neurovascular structures to the three standard portals is demonstrated. The femoral artery and nerve lie well medial to the anterior portal. The sciatic nerve lies posterior to the posterolateral portal. Small branches of the lateral femoral cutaneous nerve lie close to the anterior portal. Injury to these is avoided by using proper technique in portal placement. The anterolateral portal is established first, as it lies most centrally in the safe zone for arthroscopy. (Courtesy of J.W. Thomas Byrd, MD.)

Table 1

Distance from portal to anatomic structures (based on an anatomic dissection of portal placements in eight fresh cadaver specimens)

Table 1

Distance from portal to anatomic structures (based on an anatomic dissection of portal placements in eight fresh cadaver specimens)

Portals

Anatomic structure

Average (cm)

Range (cm)

Anterior

Anterior superior iliac spine

0 0

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