Adler Kelly L, Cook P Christopher, Yen Yi-Meng, Giordano Brian D
Division of Sports Medicine, Hip Preservation Program, Division of Sports Medicine, University of Rochester Medical Center, Rochester, New York.
Department of Orthopaedic Surgery, Division of Sports Medicine, Children's Hospital Boston, The Adolescent and Young Hip Unit, Boston, Massachusetts.
Sports Health. 2015 Nov-Dec;7(6):518-26. doi: 10.1177/1941738115587270. Epub 2015 May 18.
An evolution in conceptual understanding, coupled with technical innovations, has enabled hip preservation surgeons to address complex pathomorphologies about the hip joint to reduce pain, optimize function, and potentially increase the longevity of the native hip joint. Technical aspects of hip preservation surgeries are diverse and range from isolated arthroscopic or open procedures to hybrid procedures that combine the advantages of arthroscopy with open surgical dislocation, pelvic and/or proximal femoral osteotomy, and biologic treatments for cartilage restoration.
PubMed and CINAHL databases were searched to identify relevant scientific and review articles from January 1920 to January 2015 using the search terms hip preservation, labrum, surgical dislocation, femoroacetabular impingement, peri-acetabular osteotomy, and rotational osteotomy. Reference lists of included articles were reviewed to locate additional references of interest.
Clinical review.
Level 4.
Thoughtful individualized surgical procedures are available to optimize the femoroacetabular joint in the presence of hip dysfunction.
A comprehensive understanding of the relationship between femoral and pelvic orientation, morphology, and the development of intra-articular abnormalities is necessary to formulate a patient-specific approach to treatment with potential for a successful long-term result.
概念理解的演变与技术创新相结合,使髋关节保留外科医生能够处理髋关节的复杂病理形态,以减轻疼痛、优化功能,并有可能延长天然髋关节的使用寿命。髋关节保留手术的技术方面多种多样,从单纯的关节镜手术或开放手术到结合关节镜优势与开放手术脱位、骨盆和/或股骨近端截骨以及软骨修复生物治疗的混合手术。
检索了PubMed和CINAHL数据库,以识别1920年1月至2015年1月期间的相关科学和综述文章,检索词为髋关节保留、盂唇、手术脱位、股骨髋臼撞击症、髋臼周围截骨术和旋转截骨术。对纳入文章的参考文献列表进行了审查,以找到其他感兴趣的参考文献。
临床综述。
4级。
有经过深思熟虑的个体化手术方法可用于在髋关节功能障碍时优化股骨髋臼关节。
全面了解股骨与骨盆的方向、形态以及关节内异常的发展之间的关系,对于制定具有长期成功潜力的个体化治疗方法是必要的。