Kataoka Masanao, Goto Koji, Kuroda Yutaka, Kawai Toshiyuki, Murata Ouki, Sugimoto Masayuki, Matsuda Shuichi
Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.
Department of Orthopaedic Surgery, Nagahama City Hospital, Nagahama, Japan.
Case Rep Orthop. 2017;2017:9806863. doi: 10.1155/2017/9806863. Epub 2017 Sep 20.
Arthroscopic excision of synovial osteochondromatosis of the hip is commonly performed. However, when the lesion extends to the extra-articular space of the hip joint, excision using arthroscopy becomes difficult. Although surgical dislocation of the hip with a trochanteric flip osteotomy is commonly used, manual access to the inferomedial portion of the acetabulum remains difficult. In this case report, we describe arthroscopic resection followed by open surgery using an anterior approach with or without surgical dislocation to excise a synovial osteochondromatosis of the hip that had extended to the extra-articular space and formed a herniation sac. Excision was completed without complications. An anterior approach with or without surgical dislocation should be considered as a surgical option for the treatment of a massive synovial osteochondromatosis of the hip joint.
髋关节滑膜骨软骨瘤病的关节镜下切除术较为常用。然而,当病变延伸至髋关节的关节外间隙时,利用关节镜进行切除就变得困难。尽管常用转子翻转截骨术进行髋关节的手术脱位,但手动进入髋臼的内下部分仍然困难。在本病例报告中,我们描述了通过关节镜切除,随后采用前路开放手术(有或无手术脱位)来切除已延伸至关节外间隙并形成疝囊的髋关节滑膜骨软骨瘤病。切除过程顺利完成,无并发症。对于髋关节巨大滑膜骨软骨瘤病的治疗,有或无手术脱位的前路手术应被视为一种手术选择。