Ilizaliturri Victor M
National Rehabilitation Institute of Mexico, Amores 942-21, Colonia del Valle, Mexico City, 03100, Mexico.
Clin Orthop Relat Res. 2009 Mar;467(3):760-8. doi: 10.1007/s11999-008-0618-4. Epub 2008 Nov 19.
Recent developments in hip arthroscopy techniques and technology have made it possible in many cases to avoid open surgical technique for treating pincer-type and cam-type femoroacetabular impingement and rather treating it arthroscopically. Early reports suggest favorable results using arthroscopic techniques. The frequency of complications reported for hip arthroscopy for all indications is generally less than 1.5%, suggesting the procedure is safe. Little information is available on complications directly related to the arthroscopic treatment of femoroacetabular impingement. Failure to recognize and treat or incompletely reshape impingement deformities may be the most frequent cause for a second hip arthroscopy and redébridement of the deformity. There has been no report of avascular necrosis related to the arthroscopic treatment of femoroacetabular impingement; only one femoral neck fracture after arthroscopic cam remodeling has been reported in a large series of patients. Other clinical concerns include hip dislocation secondary to extensive capsulotomies or overresection of the anterior acetabular rim in the case of pincer impingement.
髋关节镜技术和设备的最新进展使得在许多情况下能够避免采用开放手术技术来治疗钳夹型和凸轮型股骨髋臼撞击症,而是通过关节镜进行治疗。早期报告显示,使用关节镜技术取得了良好的效果。所有适应证的髋关节镜手术并发症报告发生率通常低于1.5%,表明该手术是安全的。关于与股骨髋臼撞击症关节镜治疗直接相关的并发症的信息很少。未能识别和治疗或未完全矫正撞击畸形可能是二次髋关节镜手术和畸形再次清创的最常见原因。尚无与股骨髋臼撞击症关节镜治疗相关的缺血性坏死的报告;在一大系列患者中,仅报告了1例关节镜凸轮重塑术后股骨颈骨折。其他临床问题包括因广泛的关节囊切开术或在钳夹撞击情况下过度切除髋臼前缘而导致的髋关节脱位。