Aoki Stephen Kenji, Beckmann James Thomas, Wylie James Derek
Department of Orthopaedics, University of Utah, Salt Lake City, Utah, U.S.A.
Arthrosc Tech. 2012 Aug 17;1(2):e155-60. doi: 10.1016/j.eats.2012.05.007. Print 2012 Dec.
Establishing the introductory viewing portal is a key step in hip arthroscopy. Most hip arthroscopists initially gain access to the central compartment of the hip through the anterolateral portal. Iatrogenic injury to the labrum or the femoral head chondral surface is a common yet under-reported complication of the procedure. Instead of directing the needle toward the clear space of the distracted joint, labral penetration can be minimized by directing the needle slightly anteroinferior to the clear space, overlapping the superior femoral head. Femoral head scuffing can be minimized by adjusting the position of the beveled needle and confirming a straight guidewire trajectory before trocar placement. This technical note addresses surgical pearls to minimize iatrogenic injury during initial central compartment access.
建立初始观察入口是髋关节镜检查的关键步骤。大多数髋关节镜医师最初通过前外侧入口进入髋关节中央腔隙。盂唇或股骨头软骨表面的医源性损伤是该手术常见但报道不足的并发症。与其将穿刺针指向牵开关节的间隙，通过将穿刺针稍微指向间隙前下方、与股骨头上方重叠，可将盂唇穿刺损伤降至最低。在放置套管针之前，通过调整斜面穿刺针的位置并确认导丝轨迹笔直，可将股骨头擦伤降至最低。本技术说明介绍了在初次进入中央腔隙时将医源性损伤降至最低的手术技巧。
