Alpaugh Kyle, Shin Sangmin R, Martin Scott D
Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, U.S.A.
Orthopedic Sports Medicine Fellowship Program, Brigham and Women's Hospital, Boston, Massachusetts, U.S.A.
Arthrosc Tech. 2015 Jan 19;4(1):e23-7. doi: 10.1016/j.eats.2014.10.001. eCollection 2015 Feb.
Iatrogenic injury is a known complication of initial portal placement during hip arthroscopy. The rate of labral puncture or damage to the articular surfaces with arthroscopic instruments is variable and may be associated with operator inexperience or complex anatomy. In addition, the amount of traction applied to achieve joint distraction may unnecessarily place patients at risk of neurapraxia. The purpose of this article is to describe the "femoral head drop" technique as a method to increase safe access to the central compartment and minimize the amount of traction needed to do so, especially in patients with challenging bony anatomy. This technique uses the application of intra-articular saline solution to cause inferior migration of the femoral head. Intra-articular fluid distension, or the femoral head drop technique, is simple, safe, and reproducible, making it appropriate for hip arthroscopists at any level of experience.
医源性损伤是髋关节镜检查初次置入入路时已知的并发症。使用关节镜器械时，髋臼唇穿刺或关节面损伤的发生率各不相同，可能与术者经验不足或解剖结构复杂有关。此外，为实现关节牵开而施加的牵引量可能会不必要地使患者面临神经失用症风险。本文的目的是描述“股骨头下沉”技术，作为一种增加安全进入中央间室的方法，并尽量减少所需的牵引量，尤其是在解剖结构复杂的患者中。该技术通过关节内注入盐溶液使股骨头向下移位。关节内液体扩张，即股骨头下沉技术，简单、安全且可重复，适用于任何经验水平的髋关节镜手术医生。
