**9. Conclusion**

*Essentials in Hip and Ankle*

*7.2.1 Intra-articular contact characteristics*

*Medial, anterior and posterior roof arc angle.*

superior acetabulum.

**Figure 14.**

rior region.

through these portals.

deeply through the subcutaneous tissue.

cessful surgery can be performed.

Several studies have focused on the alteration of contact area and stresses in the joint as a result of the fracture [28–32]. All fracture patterns showed a change from a uniform contact pattern to one of increased contact area and peak pressures in the

Letournal introduced the concept of "secondary congruence" in both column fractures of the acetabulum. In this group, the complete separation of all articular acetabular bony fragments can lead to an extra anatomical orientation around the femoral head with the possibility of healing in secondary congruence. In contrast, Levine et al. found an increase of the mean pressure and peak pressure in the acetabular roof area, whereas the contact area and mean pressure between femoral head and acetabular surface was decreased significantly in the anterior articular region and on a lesser degree in the poste-

Surgical anatomy plays a pivotal role in hip arthroscopy as erroneous placement of portals can lead to injury to various important structures as described previously in the chapter. A surgeon should be well aware of various landmarks as well as vital structures around the hip joint while making portals and also while working

One of the disastrous complication of hip arthroscopy is injury to sciatic nerve or femoral nerve and vessels. Various evidences suggest that these injuries can be

Another structure that is quite often injured during hip arthroscopy id lateral femoral cutaneous nerve of thigh (LFCN). LFCN is mostly injured during anterior portal placement. Injury to this nerve leads to loss of sensation on lateral aspect of thigh. The nerve is essentially vulnerable to laceration by a skin incision placed too

Apart from these, if proper surgical anatomy is known, injury to various soft tissues around hip can also be minimized considerably. It is prudent for the surgeon to be aware of various anatomical structures around hip then only a safe and suc-

**8. Significance of surgical anatomy in hip arthroscopy**

prevented when proper technique in portal placement was used.

**20**

Anatomy has always been a second wife for a surgeon. Its role cannot be neglected whether it is a minor or major surgery. When it comes to advanced surgeries like arthroscopy requiring meticulous techniques, surgical anatomy becomes more important. If a surgeon is well versed with surgical anatomy, many iatrogenic injuries can be avoided considerably.
