New York University Hospital for Joint Diseases, 301 E 17th Street, 14th Floor, New York, NY 10003, USA.
Clin Orthop Relat Res. 2013 Apr;471(4):1277-82. doi: 10.1007/s11999-012-2627-6. Epub 2012 Oct 10.
The incidence of heterotopic ossification (HO) after hip arthroscopy reportedly ranges from less than 1.0% to 6.3%. Although open debridement has been described and a few series mention arthroscopic debridement, the techniques for arthroscopic excision of HO have not been described in detail. We describe the arthroscopic treatment of this complication.
Revision arthroscopy was completed in the central and peripheral compartments using prior portals and fluoroscopy was used to identify the HO. Spinal needle localization was used to triangulate onto the HO. Cannulas were inserted over the spinal needle. Once the HO was clearly identified with the arthroscope, it was excised using a burr and confirmed on fluoroscopy.
We retrospectively reviewed 66 patients who underwent arthroscopic treatment of femoroacetabular impingement between July 2008 and June 2010. There were 36 females and 30 males with an average age of 38 years (range, 15-68 years). Eight of the 66 (12%) patients had HO develop. Using the grading of Brooker et al., six patients had Grade 1, one had Grade 2, and one had Grade 3 HO. Three patients with HO were symptomatic and underwent arthroscopic resection. We obtained modified Harris hip scores (HHS) and radiographs at followup. The minimum followup for the three patients with revision surgery was 2 years (mean, 2 years 2 months; range, 2 years-2 years 8 months).
The three patients who underwent arthroscopic resection had HHS ranging from 85 to 96 at last followup. No patient had recurrence of HO.
Our data suggest HO is not uncommon after hip arthroscopy for the treatment of femoroacetabular impingement but most patients have minor degrees and no symptoms. In symptomatic patients, arthroscopic excision appears to relieve pain and restore function.
髋关节镜检查后异位骨化（HO）的发生率据报道从小于 1.0%到 6.3%不等。虽然已经描述了开放性清创术，并且有几个系列提到了关节镜下清创术，但 HO 的关节镜切除技术尚未详细描述。我们描述了这种并发症的关节镜治疗。
使用先前的端口完成了髋关节镜检查的中心和外周间隙，透视用于识别 HO。脊柱针定位用于将 HO 三角化。将套管插入脊柱针上。一旦用关节镜清楚地识别出 HO，就使用磨头切除，并在透视下确认。
我们回顾性分析了 2008 年 7 月至 2010 年 6 月间接受髋关节镜治疗股骨髋臼撞击症的 66 例患者。其中 36 例为女性，30 例为男性，平均年龄 38 岁（范围，15-68 岁）。66 例中有 8 例（12%）患者发生 HO。根据 Brooker 等人的分级，6 例患者为 1 级，1 例为 2 级，1 例为 3 级 HO。有 3 例有 HO 症状的患者接受了关节镜切除术。我们在随访时获得了改良 Harris 髋关节评分（HHS）和 X 线片。接受翻修手术的 3 例患者的最短随访时间为 2 年（平均，2 年 2 个月；范围，2 年-2 年 8 个月）。
3 例接受关节镜切除的患者在末次随访时的 HHS 为 85-96。没有患者出现 HO 复发。
我们的数据表明，髋关节镜检查治疗股骨髋臼撞击症后 HO 并不少见，但大多数患者程度较轻且无症状。在有症状的患者中，关节镜切除似乎可以缓解疼痛并恢复功能。
