[Expert Solution]: Operative Report PREOPERATIVE DIAGNOSIS:…

Operative Report PREOPERATIVE DIAGNOSIS: Right hip labral tear POSTOPERATIVE DIAGNOSIS: Right hip labral tear PROCEDURE: Right hip arthroscopic labral debridement OPERATIVE FINDINGS: The patient was noted to have a labral tear in the superior portion of the acetabular labrum with a frayed portion of the labrum hanging down inferiorly. Also noted to have some tearing of the tissue along the pulvinar at the attachment of the ligamentum along the acetabular side as well. INDICATION FOR PROCEDURE: The patient is a 32-year-old female complaining of right hip pain. MRI confirms evidence of a labral tear. The patient also had a diagnostic injection with relief of pain and requires a right hip arthroscopic labral debridement. All risks, benefit, alternatives, and complications of the procedure were discussed with the patient. She understands and would like to proceed. Consent is signed. PROCEDURE IN DETAIL: Right hip was marked in the pre-op holding area by the surgeon. Under general anesthesia, the patient was placed in the supine position on the Chick table with all bony prominences adequately padded. Perineal post was placed. The patient was placed in boots bilaterally and traction was applied with the patient’s hip in slight abduction and neutral rotation. Fluoroscopic images done by Radiology demonstrated an appropriate distraction. Traction was then let off. The right hip and lower extremity were then prepped and draped in the normal sterile fashion. Next, using fluoroscopic guidance, a spinal needle was passed at the anterolateral portal staying just anterior to the greater trochanter. Spinal needle was easily advanced into the hip joint. Next, Nitinol wire was passed into the hip joint. An incision was made with an 11 blade. The joint was infiltrated with saline and a trocar was placed into the hip articulation with a 5.5 cannula. Diagnostic arthroscopy was performed with the above-mentioned findings. Good placement was noted within the hip joint. Through a percutaneous incision once again, another 5.5 cannula was placed, and a soft tissue shaver and electrocautery were then used to debride the frayed tissue at the pulvinar as well as address the superior labral tear. This was probed and noted to have a flap tear, particularly on the undersurface. Using the flexible probe cautery as well as a curve and straight meniscal shaver through these cannulas by alternating between the anterolateral and anterior portals, visualization as well as addressing this labral tear with debridement was accomplished successfully, debriding the labrum back to a stable rim. Remaining labrum was then probed and noted to be stable. Final arthroscopic images were obtained. After removal of these cannulas, traction was let down and portal sites were closed with 3-0 Vicryl subcutaneous sutures followed by Steri-Strips. Sterile dressed in the operating room and transported to the recovery room without, sponge, and instrument counts were correct.