Redmond John M, Cregar William M, Gupta Asheesh, Hammarstedt Jon E, Martin Timothy J, Domb Benjamin G
Mayo Clinic Florida, Jacksonville, Florida, U.S.A.
American Hip Institute, Westmont, Illinois, U.S.A.
Arthrosc Tech. 2015 Feb 23;4(1):e87-90. doi: 10.1016/j.eats.2014.11.009. eCollection 2015 Feb.
Lateral hip pain along with tenderness of the greater trochanter has been associated with greater trochanteric pain syndrome. Radiographically, this has been associated with gluteus medius pathology on magnetic resonance imaging. This has led some surgeons to conclude that abductor pathology is a primary cause of lateral hip pain. Failure of conservative treatment in the setting of gluteus medius pathology may lead to surgical intervention. In some patients a focal tear of the gluteus medius cannot be visualized and likely represents more diffuse tendinopathy. In these patients we propose micropuncture of the greater trochanter. Similar procedures have shown effectiveness in the elbow and shoulder by eliciting a healing response. Our experience suggests that trochanteric micropuncture at the insertion of the gluteus medius tendon can be effectively performed endoscopically for gluteus medius tendinopathy.
大转子外侧疼痛伴大转子压痛与大转子疼痛综合征相关。影像学上,这与磁共振成像显示的臀中肌病变有关。这使得一些外科医生得出结论,外展肌病变是外侧髋部疼痛的主要原因。在臀中肌病变的情况下,保守治疗失败可能导致手术干预。在一些患者中,臀中肌的局灶性撕裂无法可视化,可能代表更弥漫性的肌腱病。对于这些患者,我们建议进行大转子微穿刺。类似的手术已通过引发愈合反应在肘部和肩部显示出有效性。我们的经验表明,在内窥镜下对臀中肌腱附着处进行转子微穿刺可有效治疗臀中肌腱病。