Arthroscopic management of intra-articular hip disorders in active-duty military patients

Hip arthroscopy has become an invaluable tool for addressing intra-articular hip pathology in the active-duty soldier. The surgical indications for hip arthroscopy are evolving, but our primary indications have been for hip labral tears, snapping psoas tendons, and intra-articular loose bodies. As in elite athletes, the demands placed on the hip joint by active-duty soldiers, especially in combat, are tremendous. The differential for hip pain in this population is long and broad. The most common intra-articular injury seen in this population is an acute acetabular labral tear. Clinical examination and imaging studies can often times be inconclusive in the workup of patients with labral tears. Definitive diagnosis and treatment can be obtained through hip arthroscopy. Traditionally, the treatment for hip labral tears has been debridement, but, recently, we have transitioned to repairing peripheral longitudinal tears, similar to those seen in the knee meniscus. Although long-term results are not yet known, short-term follow-up shows good to excellent results with arthroscopic acetabular labral repair. This article describes indications and surgical technique for hip arthroscopy in young active-duty soldiers.