[Extra-articular impingement of the hip : Treatment of snapping hip by lengthening of the iliotibial band]. / Extraartikuläres Weichteilimpingement am Hüftgelenk : Verlängerungsplastik des Tractus iliotibialis zur Behandlung des Traktusschnappens.

OBJECTIVE: Snapping of the iliotibial band over the greater trochanter should be eliminated by reducing tension via lengthening, release, and incision of the iliotibial band. INDICATIONS: Positive clinical examination and painful snapping of the iliotibial band over the greater trochanter, despite extensive conservative treatments, for over 6 months. CONTRAINDICATIONS: Weakness of the abductor muscles with positive Trendelenburg sign. SURGICAL TECHNIQUE: Direct approach to the iliotibial tract. The snapping of the tract over the greater trochanter can be provoked and observed in situ via internal rotation and adduction of the hip. Lengthening of the iliotibial band is performed with a tongue-shape flap technique ("Griffelschachtelplastik") directly over the greater trochanter. This leads to simultaneous release and incision over the greater trochanter. Hereafter, no snapping of the tract should be observed upon motion analysis. POSTOPERATIVE MANAGEMENT: Pain-adapted mobilization with full weightbearing, no active abduction against resistance, and no adduction over and exceeding the 0­degree level for 6 weeks. RESULTS: The snapping of the iliotibial band could be eliminated in all cases. Apart from 2 patients with previous surgery who still complain of unimproved pain, improvement of symptoms with consequent subjective satisfaction with the outcome of surgery was reported in all cases.

[Arthroscopic synovectomy of the hip joint]. / Arthroskopische Synovektomie des Hüftgelenks.

OBJECTIVE: The aim of the treatment is reduction of hip pain through arthroscopic synovectomy of the hip joint, reduction in activity of the synovial disease and removal of loose bodies in chondromatosis. INDICATIONS: Synovialitis of the hip due to synovial disease, such as pigmented villonodular synovitis (PVNS) and chondromatosis, synovialitis of the hip due to a further diseases of the hip. The disease must be treatable by arthroscopy (e.g. femoroacetabular impingement and lesion of the acetabular labrum). CONTRAINDICATIONS: Suspicion of malignant synovial disease, extensive synovitis, especially in those areas of the hip which are difficult to reach or inaccessible to arthroscopy, primary disease not sufficiently treatable by arthroscopy, e.g. coxarthrosis. SURGICAL TECHNIQUE: Arthroscopy of the central compartment of the hip is carried out by lateral, anterolateral (alternatively inferior anterolateral) and posterolateral portals, using all portals both for the camera and for instruments. In the central compartment synovectomy of the acetabular fossa is performed. A shaver and/or a high frequency diathermy applicator (HF applicator) are employed for removal of the synovial membrane. For arthroscopy of the peripheral compartment lateral, anterolateral (alternatively inferior anterolateral) and superior anterolateral portals are established and all portals are used both for the camera and instruments. In the peripheral compartment, the synovial membrane of the anterior, anteromedial, anterolateral and as far as possible posterolateral areas of the hip is removed. The dorsolateral synovial plica needs to be spared. POSTOPERATIVE MANAGEMENT: Non-steroidal anti-inflammatory drugs (NSAIDs) are administered as prophylaxis of heterotopic ossification for 10 days. Contraindications for NSAIDs need to be considered. Thrombosis prophylaxis with low molecular weight heparin over 5 days. Mobilization with full weight bearing. Intensive physiotherapeutic exercises for at least 6 and possibly up to 12 postoperative weeks. Radiosynoviorthesis 6-8 weeks after surgery depending of the histopathological results. RESULTS: From June 2007 to December 2013 a total of 20 patients with specific synovial diseases were treated with hip arthroscopy of which 18 had chondromatosis and 2 had PVNS. A telephone interview was carried out after an average of 40.2 months (range 8-92 months) and revealed a recurrence rate of the synovial disease of 20 %. In two cases (10 %) a second arthroscopy was necessary due to recurrent symptoms but without return of the synovial disease.

[Arthroscopic arthrolysis of the hip]. / Arthroskopische Arthrolyse des Hüftgelenks.

OBJECTIVE: Increase of range of motion and pain reduction for pain limited movement of the hip joint by arthroscopic arthrolysis of the peripheral compartment. INDICATIONS: Painful primary or secondary restriction of movement of the hip joint with adhesive capsulitis and after previous surgery or additional arthroscopically treatable intra-articular changes. CONTRAINDICATIONS: Extensive periarticular ossification, severe arthrofibrosis and advanced arthritis of the hip. SURGICAL TECHNIQUE: Arthroscopy of the peripheral compartment of the hip, initially using a lateral portal for the arthroscope and an anterolateral portal for instruments. After expansion of the portal entry site with a shaver and/or HF applicator and removal of scar tissue between the capsule and femoral neck, the capsule is reduced from anterolateral to anteromedial. After exchange of arthroscope and working portal, the lateral and dorsolateral arthrolysis is done. POSTOPERATIVE MANAGEMENT: Administration of nonsteroidal anti-inflammatory drugs for prophylaxis of heterotopic ossifications. Thrombosis prophylaxis with heparin. Mobilization with full weight bearing. Intensive physiotherapeutic exercises for at least for 6 weeks and if needed for 12 postoperative weeks. RESULTS: After arthroscopic (n=38) or open (n=11) hip surgeries, 49 revision hip arthroscopies were performed from January 2009 to August 2013. Arthrolysis in the described technique was performed if adhesions were present. In 19 of these cases, a limitation of at least 30 % for one direction of movement was present pre-operatively. The following average values were obtained for the range of motion (preoperative/postoperative/increase): flexion 94°/128°/34 °, abduction 18°/40°/22°, internal rotation of 8°/20°/12°, external rotation 18°/38°/20°.

[Screw arthrodesis of the shoulder]. / Schraubenarthrodese der Schulter.

OBJECTIVE: The aim of the procedure is arthrodesis of the shoulder by osteosynthesis of the glenohumeral and the acromiohumeral joint each with three screws, which results in preservation of scapulothoracic motion and pain relief. INDICATIONS: Traumatic brachial plexus lesions, palsy in infancy, poliomyelitis with preserved or restorable function of the elbow and the hand. Paralysis of the deltoid muscle and the rotator cuff. Nonrestorable vast defect of the rotator cuff with pseudoparalysis. Chronic infectious arthritis resistant to therapy. Unsuccessful attempts to treat glenohumeral instability. Alternative procedure to shoulder arthroplasty in young patients with omarthrosis, who perform hard physical work. CONTRAINDICATIONS: Insufficient strength of the scapular muscles (< grade 4, <75% of normal strength). Insufficient scapulothoracic passive motion. Inadequate soft tissue coverage after burns, excessive previous surgery or radiotherapy. Incomplete rehabilitation (<3 years) after neurosurgical interventions (neurolysis, nerve transplantation). Cases of resection of the proximal humerus. SURGICAL TECHNIQUE: Acampsia of the shoulder joint in 20° of abduction, 30° of anteversion, and 40° of internal rotation using three glenohumeral and three acromiohumeral spongiosa screws as a compression arthrodesis. POSTOPERATIVE MANAGEMENT: Thorax-arm-abduction splint (20° of abduction, 30° of anteversion, and 40° of internal rotation) until the week 6 postoperatively with removal for physiotherapy and personal hygiene. Assisted active and passive motion exercises for the elbow, hand, and fingers after the postoperative day 1. Weaning from the splint after the end of the week 6 postoperatively, full range of motion allowed. RESULTS: In a prospective study from January 2007 to September 2008, 4 patients with a medium age of 35.7 years underwent screw arthrodesis of the shoulder with a follow-up of 1.0 (0.6-1.5) year. Primary fusion of all arthrodesis surfaces was achieved in all patients; no revision surgery was necessary. All patients improved in shoulder function with an average range of motion of 60° abduction and 40° anteversion.

[Inter- and intraobserver reliability in Graf's sonographic hip examination]. / Inter- und intraindividuelle Messabweichungen in der Säuglingshüftsonografie nach Graf.

AIM: Inter- and intraobserver reliability and learning curve using Graf's ultrasonographic hip examination were assessed. MATERIAL AND METHODS: 189 participants of the basic, advanced and final courses on hip ultrasound using the Graf method (DEGUM) were asked to answer a questionnaire and to measure 34 normal and pathological sonographic hip examinations. Measurement differences and the learning curve during the different courses were evaluated. RESULTS: There was a significant (p = 0.001) improvement of the average angle between the basic (6.74 degrees [+/- 1.46 degrees ]) and the advanced course (6.22 degrees [+/- 1.17 degrees ]). However, there were no better results in the final course and no additional improvement. Participants had higher variations when measuring the beta-angle than the alpha-angle. A significant improvement was seen if the participants performed a large number of hip ultrasounds between the courses. Higher measurement differences were seen in pathological hip ultrasounds and in ultrasonographic examinations of poorer quality. CONCLUSIONS: During the educational courses on hip ultrasound using the Graf method, a high intra- and interobserver variability was seen. These findings were most prominent in measurement of the beta-angle, in pathological hip ultrasounds and in ultrasonographic hip examinations of poorer quality. The best results were achieved by participants who had performed a large number of examinations between courses. For the improvement of ultrasonographic measurements, a large number of self-performed examinations and a training in potential mistakes seem to be of great importance.

[Significance of 3D-ultrasonic examinations of the musculoskeletal system]. / Stellenwert von 3D-Ultraschall in der Orthopädie.

UNLABELLED: 3D-ultrasonic is gaining more and more significance in many medical disciplines, e. g., in angiology and prenatal diagnostics. AIM: The aim of this study was to make a comparison between the informative ability of conventional 2D-ultrasound with that of 3D-ultrasound for investigations of joints and to determinate whether 3D-ultrasound can reveal additional diagnostic information. METHOD: During a defined period of time all clinically necessary ultrasonic investigations of joints were done with a 3D-sonograph. However, all data recorded need a manual post-processing stage for visualisation in a 3D-mode. Due to the small impedance differences between the tissue layers, an automated tissue differentiation was not possible. RESULTS: The substantial advantage is that all the DEGUM standard levels can be derived from the scanning volume without conversion of the ultrasound head. CONCLUSION: At the current time the benefit of 3D-visualisation in the diagnostics of joints is small. The introduction of this technique to daily routine is not yet justified.

[Influence of the postoperative activity level on tibial bone tunnel enlargement and functional treatment results following anterior cruciate ligament reconstruction using a patellar tendon autograft]. / Der Einfluss des postoperativen Aktivitätsgrades auf die tibiale Bohrkanalerweiterung und das funktionelle Behandlungsergebnis nach vorderer Kreuzbandplastik mit Patellarsehnendrittel.

AIM: This study was performed to evaluate the influence of the postoperative activity level on tibial bone tunnel enlargement following anterior cruciate ligament reconstruction using a mid-third patellar tendon autograft. METHODS: A clinical and radiological assessment was performed on 50 patients (21 male, 29 female, mean age 32 years, range 18 to 57 years) following ACL reconstruction using a patellar tendon autograft. The average follow-up examination was performed 18 (12 to 30) months after the operation. RESULTS: 33 patients (66 %) developed a tibial bone tunnel enlargement > 1 mm. We found a positive correlation (+ 0.59) of the grade of activity and the muscle status (+ 0.56) to the tibial bone tunnel enlargement. Patients with a major tibial bone tunnel enlargement performed at a higher (p < 0.05) postoperative activity grade (5.2 versus 4.1 in the Tegner grading), rated higher in the Lysholm (88 versus 77 points) and IKDC scores (p < 0.05) and reported a better subjective functional outcome (p < 0.05). There was no significant correlation of the results of the knee stability tests and the age of the patients to the grade of tibial bone tunnel enlargement. CONCLUSIONS: In ACL reconstruction using a patellar tendon autograft we recommend early rehabilitation as the concomitant tibial bone tunnel enlargement does not significantly influence the clinical outcome or knee stability.

[Results of hip arthroscopy in sports related groin pain]. / Ergebnisse der Hüftarthroskopie bei sportabhängigen Leistenschmerzen.

INTRODUCTION: The study analyses the intraoperative findings and the clinical results of hip arthroscopy in sports related groin pain. METHODS: Between june 1998 and october 2002 we performed hip arthroscopy in 30 athletes (12 female, 18 male) with a history of sports related groin pain. Their average age was 36 (20 to 68) years. All patients had a clinical follow-up- examination at an average of 20 (12 to 48) months postoperative. The result was rated using the Larson-Score. RESULTS: We found a lesion of the acetabular labrum and performed a partial resection at 17 patients (57 %) (synovitis: n = 28 [93 %] loose bodies: n = 6 [20 %] torn ligamentum teres: n = 4 [13 %], others: n = 2 [6 %]). 11 patients (37 %) had a cartilage degeneration grade II in the Outerbridge classification (III degrees : n = 9 [30 %], I degrees : n = 4 [13 %], 0 degrees : n = 6 [20 %]). Preoperative 14 patients (47 %) complained severe groin pain (moderate: n = 14 [47 %], slight: n = 2 [6 %]) against only 3 patients (10 %) with severe groin pain at the follow-up examination (moderate: n = 11 [37 %], slight: n = 16 [53 %]). Following hip arthroscopy 28 patients (94 %) returned to full sports activity. The Larson-Score was increased significantly (p < 0.05) rating 43 (10 to 64) points preoperative to 59 (28 to 80) points at the follow-up. DISCUSSION: We found that persistent sports related groin pain was frequently caused by an intraarticular hip disorder. Following hip arthroscopy pain could be reduced in most patients as a return to full sports activity.

[Lig. capitis femoris. Arthroscopic diagnosis and treatment of degenerative and traumatic disorders]. / Lig.capitis femoris. Arthroskopische Diagnostik und Behandlung degenerativer und traumatischer Veränderungen.

The LT arises from the transverse acetabular ligament and the posterior inferior portion of the acetabular fossa and attaches to the femoral head at the fovea capitis. Lesions of the LT are accompanied by dislocation or subluxation of the hip as well as acetabular fractures. However, rupture may occur simply from a twisting injury in the absence of major trauma. Atraumatic degeneration associated with osteoarthritis and dysplasia as well as after Perthes' disease and slipped epiphysis capitis can occur. The symptoms of pain, popping, locking, and catching are nonspecific for a variety of intra-articular lesions. Most of the patients complain of deep anterior groin pain, but sometimes simply pain upon activity or loss of motion are described. No examination finding would distinguish injury to the ligament. The diagnosis of rupture of the LT remains elusive to various imaging techniques. Magnetic resonance arthrography is much more sensitive than magnetic resonance imaging at detecting various lesions but has a low sensitivity for ruptures of the LT. Lesions of the LT can be diagnosed using arthroscopy and respond remarkably well to arthroscopic débridement. Long-term results and potential consequences of treatment remain to be defined.

[Treatment of incomplete meniscal lesions in athletes]. / Die Therapie des inkompletten Meniskusrisses beim Sportler.

PURPOSE: Arthroscopic treatment of complete meniscal lesions is well established. Nevertheless there is discussion, how to treat incomplete meniscal tears, especially in younger and active patients. This study was designed to evaluate our standard-therapy without refixation of the meniscus. METHOD: Between 7/89 and 3/01 in 47 patients (48 knees, Ø age 29 years) an incomplete meniscal lesion following sports injury was found. The lesions were revitalized by "needling" or shaving. We performed no refixation. All patients had a postoperative flexion limit in an orthosis for 6 weeks. The follow-up examination was performed 6.5 (2 - 14) years postoperative. RESULTS: The avarage Lysholm-Score increased significantly from 55 points preoperative to 92 points at the follow-up examination. The Tegner-Score increased from 3.3 points preoperative to 6.2 points at the follow-up examination. The overall result was rated "exellent" and "good" by 83 % of the patients, "fair" by 15 % of the patients and "poor" by 2 % of the patients. Return to sports activity was possible at an avarage of 7 (3 - 12) months postoperative. CONCLUSIONS: In summary we found, that shaving and "needling" of an incomplete meniscal lesion in combination with partial synovectomi and standardized postoperative treatment leads to a high healing rate. A limited flexion for 6 weeks postoperativ in an orthosis at full weight bearing is recommended. In case of complete healing of the lesion the chondroprotective and joint stabilizing function of the meniscus, especially in young and active patients is obtained.

[Patellofemoral pain syndrome]. / Patellofemorales Schmerzsyndrom.

The patellofemoral pain syndrome is of high socioeconomic relevance as it most frequently occurs in young working patients. As its etiology is often unknown there is no standard treatment protocol. Several studies analyzed the different causes of patellofemoral pain and their different therapies. Static problems (pes planovalgus, instabilities, leg length differences) or chronic overuse of the knee extensor mechanism have to be identified and treated. After exclusion of intra-articular pathologies, the treatment of patellofemoral pain syndrome begins with conservative management. Stretching of the flexor and extensor muscles and training of the quadriceps muscle are the main approaches. If conservative treatment fails and patellofemoral pain persists, there are several surgical procedures for realignment of the patella in the trochlear groove and reduction of the patellofemoral pressure. Overweight patients exhibit chronic mechanical overuse of the patellofemoral joint. This leads to a higher rate of cartilage degeneration and problems at the inserting tendons and stabilizing tissues.

Trapezius transfer in brachial plexus palsy. Correlation of the outcome with muscle power and operative technique.

Between March 1994 and June 2003, 80 patients with brachial plexus palsy underwent a trapezius transfer. There were 11 women and 69 men with a mean age of 31 years (18 to 69). Before operation a full evaluation of muscle function in the affected arm was carried out. A completely flail arm was found in 37 patients (46%). Some peripheral function in the elbow and hand was seen in 43 (54%). No patient had full active movement of the elbow in combination with adequate function of the hand. Patients were followed up for a mean of 2.4 years (0.8 to 8). We performed the operations according to Saha's technique, with a modification in the last 22 cases. We demonstrated a difference in the results according to the pre-operative status of the muscles and the operative technique. The transfer resulted in an increase of function in all patients and in 74 (95%) a decrease in multidirectional instability of the shoulder. The mean increase in active abduction was from 6 degrees (0 to 45) to 34 degrees (5 to 90) at the last review. The mean forward flexion increased from 12 degrees (0 to 85) to 30 degrees (5 to 90). Abduction (41 degrees) and especially forward flexion (43 degrees) were greater when some residual function of the pectoralis major remained (n = 32). The best results were achieved in those patients with most pre-operative power of the biceps, coracobrachialis and triceps muscles (n = 7), with a mean of 42 degrees of abduction and 56 degrees of forward flexion. Active abduction (28 degrees) and forward flexion (19 degrees) were much less in completely flail shoulders (n = 34). Comparison of the 19 patients with the Saha technique and the 15 with the modified procedure, all with complete paralysis, showed the latter operation to be superior in improving shoulder stability. In all cases a decrease in instability was achieved and inferior subluxation was abolished. The results after trapezius transfer depend on the pre-operative pattern of paralysis and the operative technique. Better results can be achieved in patients who have some function of the biceps, coracobrachialis, pectoralis major and triceps muscles compared with those who have a complete palsy. A simple modification of the operation ensures a decrease in joint instability and an increase in function.

[Shoulder arthrodesis. Indications, techniques, results, complications]. / Schulterarthrodese. Indikation, Technik, Ergebnisse, Komplikationen.

Besides the paralysis of shoulder muscles, large rotator cuff tears beyond repair, persistent shoulder instability with repeat dislocations and resection cases are recent indications for shoulder arthrodesis. The fusion of the shoulder is particularly useful since, despite immobilization of the glenohumeral and acromiohumeral joints, no loss of function is experienced; on the contrary, in many cases an increase of active total mobility may occur. According to the functional outcome, the majority of reports vary between 30 degrees and 90 degrees of active abduction and forward flexion with a mean value of about 60 degrees The most generally accepted arthrodesis position is 20 degrees -40 degrees abduction, forward flexion and internal rotation in relation to the trunk. This position results in a maximum development of muscle power and ensures that the arm will rest comfortably at the side, and that the scapula will not protrude. This also allows the hand to reach the head and facial region. The literature is not confined to any uniform type of arthrodesis and it would appear that the techniques and configurations of material vary considerably. A general advantage of any one particular form of arthrodesis, and the use of plates, screws or external fixators, cannot be deduced. Pseudarthrosis appears to be less frequent in cases of plate arthrodesis compared to screw arthrodesis. However, the application of plates more often results in infections, postoperative fractures of the humerus and the necessary removal of material. Screw arthrodesis is more beneficial in that the exposed area to be operated is smaller than in plate arthrodesis. Postoperative immobilization is more time consuming and, therefore, constitutes one of the disadvantages of screw fixation.

[The brachial plexus lesion. Management, consequences of palsy and reconstructive operations]. / Der Armplexusschaden. Management, Lähmungsfolgen und funktionsverbessernde Operationen.

The treatment of traumatic brachial plexus lesions follows sequential steps. After acute therapy (phase I), neurological diagnostics (phase II), neurosurgery and postoperative treatment (phase III/IV), reconstructive operations (phase V) can be indicated and performed. In most cases an insufficient grade of muscle power remains. Within 6 months after injury, neurosurgery must be performed in patients with brachial plexus palsy. After malfunction of the muscles, taking into account the individual neuromuscular defects, passive joint function and bony deformities, different procedures such as muscle transposition, arthrodesis and corrective osteotomy can be performed to improve the function of the upper extremity. The treatment of patients suffering from brachial plexus lesion requires interdisciplinary teamwork.

[Open versus arthroscopic shoulder stabilization. An analysis of the treatment costs]. / Offene vs. arthroskopische anteriore Schulterstabilisierung. Eine Kostenvergleichsanalyse.

In this study the total costs of clinical open and arthroscopic anterior shoulder stabilization were evaluated, analyzed and compared. From 1988 to 1998 147 patients underwent open (Bankart) or arthroscopic (ASK) anterior shoulder stabilization. We randomized two groups of 30 patients for each method (Bankart: 25 male, 5 female, 29 years of age; ASK: 25 male, 5 female, 26 years of age) and evaluated the costs of their clinical treatment. The total cost was significantly ( p<0.05, Mann-Whitney U-Test) higher for the open (5639 euro) than for the arthroscopic (4601 euro) therapy. There was a significant difference between the groups for the average cost of surgery (Bankart: 2741 euro; ASK: 2315 euro, p<0.05) and the average postoperative treatment cost (Bankart: 2202 euro; ASK: 1630 euro, p<0.05) whereas the average preoperative treatment cost was not significantly different (Bankart: 669 euro, ASK: 657 euro). The staff costs for the surgical procedure (Bankart: 1800 euro (32%), ASK: 1319 euro (29%)) and the postoperative staff costs of the nurses (Bankart: 1271 euro (23%), ASK: 997 euro (22%)) represented the greatest parts of the total costs. The average duration of the clinical treatment was 15.8 days for the open- and 12,4 days for the arthroscopic group.

[Arthroscopic anterior shoulder stabilization combined with laser-assisted capsular shrinkage (LACS) compared to other procedures]. / Die arthroskopische anteriore Schulterstabilisierung durch Kombination von laserassistiertem Kapsel-Shrinkage und Nahttechnik im Vergleich mit anderen Operationsverfahren.

INTRODUCTION: Does additional laser assisted capsular shrinkage (LACS) help to reduce the recurrence rate in arthroscopic anterior shoulder stabilization? METHODS: In a prospective study from 7/97 to 4/99 at 22 nonselected patients a combined Caspari + LACS-technique was performed. We could follow-up 152 (80%) of a total 191 anterior shoulder stabilizations between 4/88 and 4/99 (124 male, 28 female, average age 33 years) (80(52%) Bankart, 30(20%) Du Toit/Roux, 20(13%) Caspari, 22(15%) Caspari + -LACS. RESULTS: The rate of dislocation was 7% (11/152) for all patients (Bankart 5% 4/80), Du Toit/Roux 4% (1/30), Caspari 25%(5/20), Caspari + LACS 5%(1/22)). Using the score of Rowe et al. [34] 113 patients (75%) rated excellent or good (Bankart 77%, Du Toit/Roux 83%, Caspari 60%, Caspari + LACS 86%). CONCLUSIONS: An additional laser capsular shrinkage helps to reduce the high rates of dislocation in arthroscopic anterior shoulder stabilization with results similar to standard open procedures.

[Arthroscopy of the hip]. / Hüftarthroskopie.

Arthroscopy of the hip has become a well-established procedure for minimally invasive therapy of hip disorders. The surgical technique is demanding. A fracture table for distraction of the joint is required, as well as an exact positioning technique is most important. Because of eh great distance between skin and joint only restrictive intrarticular maneuvers are possible. Arthroscopically the hip can be divided into a central and peripheral compartment. For arthroscopy of the central compartment distraction of the joint is necessary. This part comprises the loaded surface of the femoral head and the lunate cartilage. The peripheral compartment consists of the unloaded cartilage of the femoral head and the femoral neck until the capsular insertion. This compartment can be visualized without traction. Good results can be achieved in the therapy of labral lesions, loose bodies, moderate osteoarthritis, synovial diseases and pathology of the teres ligament. Performing hip arthroscopy in an adequate technique and under consideration of contraindications, complications are rare.