Forget the Greater Trochanter! Hip Joint Access With the 12 O'clock Portal in Hip Arthroscopy

Overview

Journal Arthrosc Tech

Publisher Elsevier

Date 2019 Jul 24

PMID 31334013

Citations 12

Authors

David R Maldonado

Jeffrey W Chen

Rafael Walker-Santiago

Philip J Rosinsky

Jacob Shapira

Ajay C Lall

Benjamin G Domb

Affiliations

Soon will be listed here.

Abstract

Most surgeons rely on the greater trochanter as the reference point to establish the anterolateral portal. Nevertheless, we believe that the anterosuperior iliac spine is a more reliable landmark. Unlike the greater trochanter, it is unaffected by leg rotation and is more easily identified by palpation. Abiding by the central tenet of medicine to "do no harm," the technique described herein presents in detail the concept of the 12 o'clock portal placement, a hip joint access method based on identifying specific anatomic points under fluoroscopy and by palpation. To accomplish this goal, this Technical Note presents a step-by-step approach, including tips and pearls for patient positioning and fluoroscopic guidance. We believe this method ensures a reproducible and safe way to start hip arthroscopy in the supine position.

Citing Articles

Percutaneous Intraarticular Peripheral Access Technique for Hip Arthroscopy.

Carbone A, Harris W, McCarroll T, Kufta A, Walsh E, Domb B Arthrosc Tech. 2025; 14(2):103232.

PMID: 40041359 PMC: 11873480. DOI: 10.1016/j.eats.2024.103232.

Setting Sail in Hip Arthroscopy: The "Rudder Technique" for Spinal Needle Access Through the Mid-anterior Portal.

McCarroll T, Kahana-Rojkind A, Keane J, Schab A, Kuhns B, Domb B Arthrosc Tech. 2025; 14(2):103191.

PMID: 40041333 PMC: 11873467. DOI: 10.1016/j.eats.2024.103191.

Hip Capsular Closure in Distraction: A Technique to Allow Easier Closure of T and Interportal Capsulotomies.

Ozbek E, Miller L, James M, Mauro C Arthrosc Tech. 2023; 12(8):e1305-e1309.

PMID: 37654878 PMC: 10466195. DOI: 10.1016/j.eats.2023.03.023.

The Circumferential Femoroplasty: An All-Arthroscopic Technique for Addressing a Challenging Hip Deformity.

Owens J, Saks B, Fox J, Jimenez A, Lall A, Domb B Arthrosc Tech. 2022; 11(10):e1737-e1745.

PMID: 36311314 PMC: 9596604. DOI: 10.1016/j.eats.2022.06.009.

Anchor Arthropathy Caused by Cartilage Penetration: An Approach to Revision Hip Arthroscopy With Removal of Problematic Anchors.

Sabetian P, Paraschos O, Harris W, Padilla P, Maldonado D, Domb B Arthrosc Tech. 2022; 11(10):e1689-e1694.

PMID: 36311313 PMC: 9596390. DOI: 10.1016/j.eats.2022.06.003.

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