Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 North St Claire, Suite 1350, Chicago, IL 60611, USA.
Am J Sports Med. 2013 May;41(5):1174-89. doi: 10.1177/0363546513476281. Epub 2013 Feb 28.
Arthroscopic surgery in the hip joint has historically lagged behind its counterparts in the shoulder and knee. However, the management of hip injuries in the athletic population has rapidly evolved over the past decade with our improved understanding of mechanical hip pathology as well as the marked improvement in imaging modalities and arthroscopic techniques. Current indications for hip arthroscopic surgery may include symptomatic labral tears, femoroacetabular impingement (FAI), hip capsular laxity/instability, chondral lesions, disorders of the peritrochanteric or deep gluteal space, septic joint, loose bodies, and ligamentum teres injuries. Furthermore, hip arthroscopic surgery is developing an increasingly important role as an adjunct diagnostic and therapeutic tool in conjunction with open femoral and/or periacetabular osteotomy for complex hip deformities. Arthroscopic techniques have evolved to allow for effective and comprehensive treatment of various hip deformities. Techniques for extensile arthroscopic capsulotomies have allowed for improved central and peripheral compartment exposure and access for labral takedown, refixation, treatment of chondral injury, and osteochondroplasty of the femoral head-neck junction and acetabular rim. While favorable short-term and midterm clinical outcomes have been reported after arthroscopic treatment of prearthritic hip lesions, greater long-term follow-up is necessary to assess the efficacy of hip arthroscopic surgery in altering the natural history and progressive degenerative changes associated with FAI.
髋关节的关节镜手术在历史上一直落后于肩关节和膝关节的关节镜手术。然而，在过去十年中，随着我们对机械性髋关节病理学的理解不断提高，以及影像学和关节镜技术的显著改善，运动人群中髋关节损伤的治疗方法迅速发展。目前髋关节关节镜手术的适应证可能包括有症状的盂唇撕裂、股骨髋臼撞击症（FAI）、髋关节囊松弛/不稳定、软骨病变、髋关节周围或臀深部间隙病变、感染性关节、游离体和圆韧带损伤。此外，髋关节关节镜手术作为一种辅助诊断和治疗工具，与开放性股骨和/或髋臼周围截骨术联合用于复杂的髋关节畸形，其作用日益重要。关节镜技术已经发展到可以有效地治疗各种髋关节畸形。广泛的关节镜下囊切开术技术可以改善中央和外周间隙的显露和进入，以便进行盂唇切除、修复、软骨损伤治疗和股骨头颈交界处及髋臼缘的骨软骨成形术。虽然髋关节镜治疗髋关节前关节炎病变的短期和中期临床结果良好，但需要更长时间的随访来评估髋关节镜手术对改变与 FAI 相关的自然病史和进行性退行性改变的疗效。
