Lee Simon, Haro Marc S, Riff Andrew, Bush-Joseph Charles A, Nho Shane J
Rush University Medical Center, Chicago, Illinois, U.S.A.
Arthrosc Tech. 2015 Jan 26;4(1):e41-6. doi: 10.1016/j.eats.2014.11.003. eCollection 2015 Feb.
Open synovectomy remains the treatment of choice for pigmented villonodular synovitis (PVNS) of the hip but has shown modest results compared with the treatment of other joints. Recent advances in hip arthroscopy permit a thorough evaluation of the joint surfaces, improved access, and decreased postoperative morbidity. We describe an arthroscopic synovectomy technique for PVNS of the hip. The use of additional arthroscopic portals and creation of a large capsulotomy enable successful visualization and extensive synovectomy of the entire synovial lining of the hip. The T-capsulotomy enables extensive soft-tissue retraction for complete exposure. The midanterior portal enables use of an arthroscopic grasper and shaver to directly access and excise the synovial lining of the peripheral compartment while avoiding damage to the medial and lateral retinacular vessels. Technical innovations in hip arthroscopy have enhanced visualization in the central and peripheral compartments, as well as instrument management and diagnostic evaluation of the capsule, therefore allowing enhanced management of PVNS of the hip.
开放性滑膜切除术仍是治疗髋关节色素沉着绒毛结节性滑膜炎（PVNS）的首选方法，但与其他关节的治疗相比，效果并不理想。髋关节镜技术的最新进展使得能够对关节表面进行全面评估，改善手术入路，并降低术后发病率。我们描述了一种用于髋关节PVNS的关节镜滑膜切除术技术。使用额外的关节镜入口和进行大的关节囊切开术能够成功地可视化并广泛切除髋关节整个滑膜衬里。T形关节囊切开术能够广泛牵拉软组织以实现完全暴露。前正中入口能够使用关节镜抓钳和刨刀直接进入并切除外周间隙的滑膜衬里，同时避免损伤内侧和外侧支持带血管。髋关节镜技术的创新提高了中央和外周间隙的可视化程度，以及对关节囊的器械操作和诊断评估，从而改善了髋关节PVNS的治疗。
