Voos James E, Rudzki Jonas R, Shindle Michael K, Martin Hal, Kelly Bryan T
Hospital for Special Surgery, New York, New York 10021, USA.
Arthroscopy. 2007 Nov;23(11):1246.e1-5. doi: 10.1016/j.arthro.2006.12.014. Epub 2007 Apr 5.
Disorders of the lateral or peritrochanteric space (often grouped into the greater trochanteric pain syndrome), such as recalcitrant trochanteric bursitis, external snapping iliotibial band, and gluteus medius and minimus tears, are now being treated endoscopically. We outline the endoscopic anatomy of the peritrochanteric space of the hip and describe surgical techniques for the treatment of these entities. Proper portal placement is key in understanding the peritrochanteric space and should be first oriented at the gluteus maximus insertion into the linea aspera, as well as the vastus lateralis. When tears of the gluteus medius and minimus are encountered, suture anchors can be placed into the footprint of the abductor tendons in a standard arthroscopic fashion. Our initial experience indicates that recalcitrant trochanteric bursitis, external coxa saltans, and focal, isolated tears of the gluteus medius and minimus tendon may be successfully treated with arthroscopic bursectomy, iliotibial band release, and decompression of the peritrochanteric space and suture anchor tendon repair to the greater trochanter, respectively.
外侧或转子周围间隙疾病（常归类为大转子疼痛综合征），如顽固性转子滑囊炎、髂胫束外弹响以及臀中肌和臀小肌撕裂，目前正在通过内镜进行治疗。我们概述了髋关节转子周围间隙的内镜解剖结构，并描述了治疗这些病症的手术技术。正确的切口位置是了解转子周围间隙的关键，首先应定位在臀大肌插入粗线处以及股外侧肌处。当遇到臀中肌和臀小肌撕裂时，可采用标准关节镜技术将缝合锚钉置入外展肌腱附着点。我们的初步经验表明，顽固性转子滑囊炎、髋关节外弹响以及臀中肌和臀小肌腱的局限性、孤立性撕裂，分别可通过关节镜下滑囊切除术、髂胫束松解术、转子周围间隙减压术以及将缝合锚钉固定于大转子的肌腱修复术成功治疗。
