Di Pietto F, Chianca V, de Ritis R, Cesarano E, Reginelli A, Barile A, Zappia M, Ginolfi L
Department of Radiology, Cardarelli Hospital, Naples, Italy.
AORN A. Cardarelli, Via A. Cardarelli, 9, 80131, Naples, Italy.
Musculoskelet Surg. 2017 Mar;101(Suppl 1):43-49. doi: 10.1007/s12306-017-0459-y. Epub 2017 Feb 16.
Arthroscopic surgery of the hip, compared to that of the knee or the shoulder, has only recently been developed in any significant way. Current indications for arthroscopic surgery of the hip include: diagnosis and treatment of lesions symptomatic of the acetabular labrum, femoroacetabular impingement (FAI), chondral lesions, joint infections, lesions of the teres ligament, impingement of the psoas tendon, pathology of the peritrochanteric space, external snapping hip (coxa saltans), and traumatic and atraumatic instability. Principal indications for imaging of the hip with arthroscopic techniques are represented by persistent groin pain which may be caused by inadequate recognition or treatment of bone alteration of FAI, fractures in the site of resectioned bones, intra-articular adhesion, development of cartilaginous lesions, iatrogenic chondral lesions, recurrent lesions of the fibrocartilaginous acetabular labrum and heterotopic ossification. Postoperative checkup examinations can be undertaken with conventional radiography. The appearance or persistence of groin pain may be investigated using MRI, arthro-MRI and even CT scans.
与膝关节或肩关节的关节镜手术相比,髋关节的关节镜手术只是最近才得到显著发展。目前髋关节关节镜手术的适应症包括:髋臼盂唇病变、股骨髋臼撞击症(FAI)、软骨损伤、关节感染、圆韧带损伤、腰大肌腱撞击、转子周围间隙病变、外侧弹响髋(跳跃征)以及创伤性和非创伤性不稳定的诊断和治疗。采用关节镜技术对髋关节进行成像的主要适应症表现为持续的腹股沟疼痛,这可能是由于对FAI的骨质改变认识不足或治疗不当、切除部位的骨折、关节内粘连、软骨损伤的发展、医源性软骨损伤、髋臼纤维软骨盂唇的复发性病变以及异位骨化所致。术后检查可采用传统X线摄影。腹股沟疼痛的出现或持续存在可通过MRI、关节造影MRI甚至CT扫描进行检查。