Ilizaliturri Victor M, Orozco-Rodriguez Liliana, Acosta-Rodríguez Eduardo, Camacho-Galindo Javier
Adult Joint Reconstruction Service of the National Rehabilitation Institute of Mexico, Mexico City, Mexico.
J Arthroplasty. 2008 Feb;23(2):226-34. doi: 10.1016/j.arth.2007.03.016. Epub 2007 Oct 24.
Femoroacetabular impingement is defined as anterior hip abutment between the acetabular rim and proximal femur. When it is secondary to acetabular overcoverage, it is pincer impingement. When it is secondary to femoral head and neck deformity, it is cam impingement. Open remodeling of impinging deformities is the standard treatment of this condition. We describe arthroscopic treatment of cam impingement in 19 patients using standard hip arthroscopy portals by the lateral approach. Sixteen patients improved their symptoms after the procedure; and 3 patients deteriorated, with 1 needing a total hip arthroplasty at 2 years follow-up. We had no cases with postoperative femoral neck fractures or avascular necrosis. Hip arthroscopy can be successfully used to treat cam impingement. The precautions used in open surgery to preserve femoral neck bone stock and hip vascularity should be followed.
股骨髋臼撞击症被定义为髋臼边缘与股骨近端之间的髋关节前方撞击。当它继发于髋臼过度覆盖时,为钳夹型撞击。当它继发于股骨头和颈部畸形时,为凸轮型撞击。对撞击畸形进行开放重塑是这种疾病的标准治疗方法。我们描述了通过外侧入路使用标准髋关节镜入路对19例凸轮型撞击症患者进行关节镜治疗。16例患者术后症状改善;3例患者症状恶化,其中1例在2年随访时需要进行全髋关节置换术。我们没有出现术后股骨颈骨折或缺血性坏死的病例。髋关节镜可成功用于治疗凸轮型撞击症。应遵循开放手术中用于保留股骨颈骨量和髋关节血运的注意事项。