MedSport, Division of Sports Medicine and Shoulder Surgery, University of Michigan, Ann Arbor, 48106, USA.
Arthroscopy. 2011 Dec;27(12):1720-31. doi: 10.1016/j.arthro.2011.08.288. Epub 2011 Nov 1.
Advances in the ability to treat various soft-tissue and osseous pathologic conditions of the hip arthroscopically have been predicated on an improved exposure of the pathology of the central, peripheral, and peritrochanteric compartments. The management of the capsule is critical and must allow for an improved exposure without compromising stability and kinematics of the hip. Described approaches have included capsulectomy, limited capsulotomy, extensile capsulotomy, capsular plication, and capsular shift. The selected approach must consider various factors, including symptomatic complaints, underlying hyperlaxity, specific mechanical pathology, and surgical expertise. Universally using a single technique without consideration of the complex mechanical and anatomic factors unique to each patient may result in incomplete treatment of the pathoanatomy or iatrogenic instability. This article reviews the anatomy of the hip capsule and provide a diagnosis-based consideration of capsular management during hip arthroscopy. The senior author's preferred techniques are also presented.
髋关节镜下治疗各种软组织和骨性病损能力的提高，是基于对中央、周围和股骨颈周围间隙病损的显露的改善。关节囊的处理至关重要，必须在不影响髋关节稳定性和运动学的情况下提供更好的显露。已描述的方法包括关节囊切除术、有限的关节囊切开术、广泛的关节囊切开术、关节囊折叠术和关节囊移位术。选择的方法必须考虑到各种因素，包括症状投诉、潜在的过度松弛、特定的机械病理学和手术专业知识。如果不考虑每个患者特有的复杂机械和解剖因素，普遍使用单一技术可能会导致对病理解剖或医源性不稳定的治疗不完整。本文回顾了髋关节囊的解剖结构，并根据髋关节镜检查中髋关节囊的管理提供了基于诊断的考虑。还介绍了资深作者的首选技术。
