Arthroscopic treatment of unstable total hip replacement.

Hip arthroscopy may be useful in the diagnosis and treatment of apparently well-implanted but unstable total hip replacement prostheses. We present 2 cases of arthroscopically assisted capsular tightening in unstable total hip replacements. Both cases had significant capsular laxity. Case 2 had impingement of the lower part of the acetabulum with the lesser trochanter that caused hip dislocation. Early revision surgery can be avoided with the use of this technique in selected cases of unstable total hip replacements.

Arthroscopic technique for the treatment of patellar chondral lesions with the patient in the supine position.

We describe an arthroscopic approach for the treatment of patellar chondral lesions with the patient in the supine position. This approach can be used to perform certain procedures such as matrix autologous chondrocyte implantation and autologous matrix-induced chondrogenesis. It is possible to perform these arthroscopic techniques working at an angle perpendicular to the patellar joint surface. First, with the patient in the supine position, arthroscopic longitudinal sectioning of the lateral patellar retinaculum is performed, and the patella is reverted with the help of a Codivilla forceps. It is then possible to place the chondral surface perpendicular to the floor, and it can be accessed directly through a lateral parapatellar portal. Short-term follow-up has shown the benignity of opening the patellar retinaculum. This procedure reduces morbidity compared with the traditional open surgery.