Surgical Technique of the "Up-The-Neck" View During Hip Arthroscopy for Femoroacetabular Impingement.

Mengers, Sunita R; Strony, John T; Vakharia, Ajit; Su, Charles A; Edwards, Gary; Salata, Michael J · Arthrosc Tech · 2022

expert_opinion · Level V

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Abstract

In the setting of femoroacetabular impingement, arthroscopy versus open surgery confers many advantages. However, inadequate bony resection remains a concern and is the leading cause of revision surgery. Several strategies have been described to ensure a more-complete resection during hip arthroscopy. In this current technique article, the authors describe a modified anterior portal site view called the "up-the-neck" view. This view allows for greater visualization of the femoral head-neck junction and alleviates challenges faced when assessing resection intraoperatively. The "up-the-neck" view is achieved by placing a 70° arthroscope in the anterior lateral portal and subsequently rotating the camera 90°. The head-neck junction will appear horizontally, rather than vertically, on this view, which allows for the easy identification of missed imperfections. This may reduce the need for revision surgery and future investigation is necessary to determine the reoperation rates following this technique.

Anatomy