Hip arthroscopy and the surgical drapes applied. The next step is to insert a fine needle under x-ray guidance into the hip joint. This breaks the 'suction seal' of the joint and allows further distraction if necessary (see fig 4). The surgeon wishes to see the ball move out the socket by approximately 1 cm, so that access to the hip joint can be achieved with minimal risk of damage to the joint surfaces. Most surgeons will inject fluid into the joint at this stage, again to ensure that there is enough space between the ball and socket for safe instrument access.
Hip arthroscopy any further portals may be created once the camera is in position, to ensure that they are placed with minimal risk to the joint surfaces. This process can be repeated to gain as many points of entry to the hip joint as the surgeon requires, normally between two and four. Certain of these entry points will be used for the viewing arthroscope and others for operating instruments. The operation then begins, a variety of instruments being used. While the surgeon views the interior of the hip joint through the arthroscope, other operating instruments are introduced through the other portals. Once