Position and distraction options

Successful hip arthroscopy relies on safe and effective access. Regardless of a supine or lateral approach to the hip, one relies on traction to access the central compartment of the hip and a stable positioning system to facilitate exposure to the peripheral compartment. This chapter outlines the importance of an operative approach to hip arthroscopy that includes operative theater preparation, patient positioning, hip distraction systems, and methods to avoid the pitfalls and complications of hip arthroscopy access. Upon completion of the chapter, the reader will have an improved understanding of the importance of hip distraction in hip arthroscopy, an appreciation of the variety of commercial hip distractors available for hip arthroscopy, and a watch list of complications related to over- or underdistraction to avoid during a hip arthroscopy procedure.