Peritrochanteric Endoscopy Through Standard Hip Arthroscopy Portals: A Stepwise Approach for Diagnostic Evaluation.

Abstract

Peritrochanteric endoscopy allows direct visualization of abductor tendons, the iliotibial band, and the trochanteric bursa, and it can be seamlessly performed at the conclusion of hip arthroscopy using the same portals. This Technical Note outlines a systematic approach to access and evaluate the peritrochanteric space endoscopically without repositioning or redraping. The technique emphasizes safe cannula placement using fluoroscopy, blunt dissection under the iliotibial band, and a methodical diagnostic survey of the gluteus medius, gluteus minimus, vastus lateralis, gluteus maximus insertion, and overlying structures. This approach facilitates early identification of pathology that may be missed on magnetic resonance imaging and guides decision-making for further treatment. Early diagnostic access may improve clinical outcomes by enabling timely identification and treatment of extra-articular pathology within the same surgical session.