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The ‘upper deck view’ improves visualization during acetabuloplasty without chondro-labral detachment

The 'upper deck' view is an arthroscopic perspective which visualizes the labral-osseous junction without detachment of the chondro-labral junction. The aim of this study was to evaluate the utility of the 'upper deck' view in preventing incomplete acetabuloplasty. Data were prospectively collected from September 2016 to November 2016 for all hip arthroscopies. We recorded the amount and clock-face of residual pincer-lesion acetabular bone resected using the 'upper deck' view. We noted whether this residual pincer-lesion acetabular bone was visible fluoroscopically, as well as the amount and clock-face of the overall acetabuloplasty. During the study period, 87 hip arthroscopies were performed; 50 met the inclusion criteria. Forty-six (92%) patients had residual pincer-lesion acetabular bone after completion of the acetabuloplasty resected from the bird's eye view. In all such cases the residual pincer-lesion acetabular bone was not visible under fluoroscopy and could only be detected using this specific view. The average maximum resection for the acetabuloplasty was 2.1 ± 0.9 and 1.4 ± 0.5 mm (P = 0.16) for resection of residual pincer-lesion acetabular bone. The 'upper deck' view provides the ability to decrease the risk of incomplete acetabuloplasty, due to the high likelihood (92%) of a residual beak of pincer-lesion acetabular bone when this view is not used during rim trimming.

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