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Joint distraction was measured via JSW on fluoroscopic and ultrasound images. A single, fellowship\u2010trained orthopaedic surgeon established anterolateral arthroscopy portals via ultrasound or fluoroscopic guidance in a randomized sequence. Total procedure time, number of times the spinal needle pierced the capsule, and iatrogenic chondral or labral injury were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve full\u2010body specimens (20 hips) underwent distraction, and 17 hips underwent portal placement with\u00a0fluoroscopic (n\u00a0= 8) or ultrasound (n\u00a0= 9) guidance. JSW measured on ultrasound was significantly less laterally (13.0 vs 9.2 mm,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), apically (16.7 vs 9.2 mm,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and medially (17.9 vs 9.2 mm,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Successful portal entry was achieved in every specimen. Average procedure time was 133 \u00b1 51 seconds for the fluoroscopy group and 371 \u00b1 260 seconds for the ultrasound group (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .026). Fluoroscopic guidance required significantly less needle insertion attempts at 1.13 compared with 3.33 attempts for ultrasound (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .022). Labral damage was greater in the ultrasound group at 66.67% compared with 12.50% for fluoroscopy (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .0497).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Joint distraction measured on ultrasound\u00a0can be used to subjectively determine if the joint is adequately distracted in hip arthroscopy. Ultrasound\u2010guided portal placement was associated with more needle insertion attempts, iatrogenic injury of the labrum, and overall procedure time in comparison to fluoroscopic guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Fluoroscopy is the gold standard to confirm adequate joint distraction, aid in establishing arthroscopy portals, and evaluate resection of the femoral head during hip arthroscopy but exposes the patient to ionizing radiation, requires additional operators in the operating room, and involves the need for a heavy lead shield. Alternatives to fluoroscopy are needed, but ultrasound has not proven superior in our cadaveric model.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2022.03.005","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T01:19:32Z","timestamp":1653355172000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["Ultrasound Can Determine Joint Distraction During Hip Arthroscopy but Fluoroscopic\u2010Guided Portal Placement Is Superior"],"prefix":"10.1002","volume":"4","author":[{"given":"Nicholas A.","family":"Trasolini","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Wake Forest Baptist Medical Center Winston\u2010Salem North Carolina U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmanan","family":"Sivasundaram","sequence":"additional","affiliation":[{"name":"Section of Young Adult Hip Surgery Division of Sports Medicine Department of Orthopedic Surgery Rush Medical College of Rush University Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan W.","family":"Rice","sequence":"additional","affiliation":[{"name":"Section of Young Adult Hip Surgery Division of Sports Medicine Department of Orthopedic Surgery Rush Medical College of Rush University Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safa","family":"Gursoy","sequence":"additional","affiliation":[{"name":"Section of Young Adult Hip Surgery Division of Sports Medicine Department of Orthopedic Surgery Rush Medical College of Rush University Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian M.","family":"Clapp","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Utah School of Medicine Salt Lake City Utah U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Alter","sequence":"additional","affiliation":[{"name":"Section of Young Adult Hip Surgery Division of Sports Medicine Department of Orthopedic Surgery Rush Medical College of Rush University Rush University Medical Center Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9fano","family":"Gaggiotti","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Service Hospital Brit\u00e1nico de Buenos Aires Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane J.","family":"Nho","sequence":"additional","affiliation":[{"name":"Section of Young Adult Hip Surgery Division of Sports Medicine Department of Orthopedic Surgery Rush Medical College of Rush University Rush University Medical Center Chicago Illinois 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Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}