title: Accessibility of extra-articular pathologies of iliopsoas tendon and bursitis of greater trochanter in hip arthroscopy.
abstract: OBJECTIVE
  Different pathologies leading to psoas tendon pain and chronic bursitis of the greater trochanter are well known. The purpose of the study was to underline the accessibility of the psoas tendon at lesser trochanter, reproduce the results and measure the distances to anatomical landmarks.
  
  
  METHODS
  Twelve hips of six human cadavers underwent hip arthroscopy. The accessibility of the iliopsoas tendon at the lesser trochanter and the bursa at the greater trochanter was documented with the camera. In addition to the usual access portals, alternative ventral ports were analysed concerning accessibility of the lesser trochanter. Afterwards, arthroscopy needles were placed along the extra-articular portals followed by dissection. The distances of the portals in relation to important anatomical landmarks were analysed.
  
  
  RESULTS
  The accessibility to the iliopsoas tendon at the lesser trochanter and to the bursa at the greater trochanter throughout the conventional portals was reproducible. Sufficient distances to the important anatomical landmarks could be shown. The mean distance of the distal ventro-lateral and the wide distal ventro-lateral portal to the nervous cutaneous femoris lateralis was 26.8 ± 5.4 mm and 32.2 ± 3.9 mm. The mean distance from the more ventral located portals to the nervous arteria and vena femoralis was 28.3 ± 2.1 mm.
  
  
  CONCLUSIONS
  This is the first study known to us that describes in detail the accessibility of the extra-articular structures underlined by anatomical preparation. In addition, it was demonstrated that a more ventrally located portal had sufficient distance to the important neurovascular structures of the ventral femur and can also be used in addendum if necessary.
authors: Center for Hip, Knee and Foot Surgery, Sports Traumatology, ATOS Clinic Heidelberg, Bismarckstr. 9-15, 69115, Heidelberg, Germany. fritz.thorey@atos.de
authors: Fritz
authors: F
authors: Thorey
authors: Stefan
authors: S
authors: Budde
authors: Max
authors: M
authors: Ettinger
authors: Urs Vito
authors: UV
authors: Albrecht
authors: Marco
authors: M
authors: Ezechieli
mesh_terms: D000328:Adult; D001182:Arthroscopy; D002061:Bursa, Synovial / Q000033:anatomy & histology; D002102:Cadaver; D005260:Female; D005263:Femoral Artery / Q000033:anatomy & histology; D005267:Femoral Nerve / Q000033:anatomy & histology; D005268:Femoral Vein / Q000033:anatomy & histology; D006621:Hip Joint / Q000033:anatomy & histology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013710:Tendons / Q000033:anatomy & histology* / Q000601:surgery; D058971:Tenotomy