Setting Sail in Hip Arthroscopy: The "Rudder Technique" for Spinal Needle Access Through the Mid-anterior Portal.

McCarroll, Tyler R; Kahana-Rojkind, Ady H; Keane, Jessica C; Schab, Andrew R; Kuhns, Benjamin D; Domb, Benjamin G · Arthrosc Tech · 2025

expert_opinion · Level V

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Abstract

Hip arthroscopy is a technically demanding procedure with a steep learning curve. Even accessing the hip joint, if performed improperly, will make the remainder of the case more difficult and potentially cause iatrogenic injury. Much like the rudder of a boat, the spinal needle bevel edge can be steered through tissue in a manner to ensure smooth sailing when accessing the hip. The purpose of this article is to provide a better understanding of how to maximize the capabilities of a bevel-edge needle through use of the "rudder technique" to gain access in a more efficient and atraumatic fashion.

Anatomy