Doron Ran, Amar Eyal, Rath Ehud, Sampson Thomas, Ochiai Derek, Matsuda Dean K
Department of Orthopedics, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Hip Arthroscopy Department, Post Street Orthopaedics and Sports Medicine, San Francisco, California.
Arthrosc Tech. 2014 Dec 22;3(6):e723-5. doi: 10.1016/j.eats.2014.09.003. eCollection 2014 Dec.
Adequate traction to achieve hip joint distraction is essential for avoiding iatrogenic injury to the joint during hip arthroscopy. An inability to distract the joint is a relative contraindication for hip arthroscopy. This report describes a novel technique involving an extracapsular approach to gain safe access to a hip joint that fails a trial of traction during positioning for hip arthroscopy. The anterolateral portal is established under fluoroscopic guidance. The arthroscope is positioned on the lateral rim of the acetabulum. A shaver, introduced through a modified anterior portal, is used to facilitate capsular exposure. An arthroscopic capsular incision is made proximal to the lateral acetabular rim and extended anteriorly with a radiofrequency probe. Osteoplasty of the anterolateral acetabular rim is carried out with a burr while protecting the labrum. Distraction of the hip is then possible, allowing safe central-compartment access and subsequent chondrolabral procedures.
在髋关节镜检查期间，获得足够的牵引力以实现髋关节牵开对于避免医源性关节损伤至关重要。无法牵开关节是髋关节镜检查的相对禁忌证。本报告描述了一种新技术，该技术涉及通过关节囊外入路安全进入在髋关节镜检查定位时牵引试验失败的髋关节。在透视引导下建立前外侧入路。将关节镜置于髋臼外侧边缘。通过改良的前入路插入刨削器，用于促进关节囊暴露。在髋臼外侧边缘近端进行关节镜下关节囊切开，并用射频探头向前延伸。在保护盂唇的同时，用磨钻对髋臼前外侧边缘进行骨成形术。然后可以牵开髋关节，从而安全进入中央腔并进行后续的软骨盂唇手术。
