Hip arthroscopy in the lateral position

The hip joint is the most deeply recessed joint in the body, making it difficult to access arthroscopically. Thelateral position facilitates peritrochanteric approaches, which provide reproducible bony landmarks for orientation, as well as access for most pathology within the hip joint. Minimally invasive approaches to the hip joint have been developed for situations where open techniques are less advantageous, such as the patient with a symptomatic loose body or labral tear. The different portals have varying abilities to visualize different anatomic structures. Knowledge of anatomic relationships is of utmost importance in the use of the various portals. Meticulous attention to proper positioning, adequate joint distraction, and portal placement is paramount for safe and successful arthroscopy of the hip. This article will review the seminal features of lateral positioning and minimally invasive surgical approaches to the hip.