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Stepwise Safe Access in Hip Arthroscopy in the Supine Position: Tips and Pearls From A to Z

Hip arthroscopy is rapidly growing as a treatment with good outcomes for pathologic conditions such as femoroacetabular impingement syndrome and labral tears. At the same time, it is one of the most technically challenging and demanding procedures in orthopaedics with a technically demanding skill. The first challenge is to safely access the joint, which requires accurate anatomical knowledge, a strong sense of spatial orientation, and repeated practice. Iatrogenic chondrolabral injury has been reported as the most common complication in hip arthroscopy and most frequently occurs during hip joint access. As such, basic foundations cannot be overstated. These complications can be minimized with adequate patient positioning, reproducible hip joint access techniques, and proper portals placement. Nonetheless, these three points are perhaps the greatest hurdles that orthopaedic surgeons face when entering the hip arthroscopy field. In this review, we outlined a stepwise approach for a safe access to hip arthroscopy.