Skelley Nathan W, Conaway William K, Martin Scott D
Department of Orthopaedic Surgery, Massachusetts General Hospital-Harvard Medical School, Boston, Massachusetts, U.S.A.
Arthrosc Tech. 2017 Oct 9;6(5):e1807-e1813. doi: 10.1016/j.eats.2017.06.061. eCollection 2017 Oct.
The prevalence of hip arthroscopy has increased exponentially with the advent of arthroscopic labral repair techniques for femoroacetabular impingement. The goal of arthroscopic labral repair is to re-create the anatomic suction seal of the labrum against the femoral head. This important anatomic relationship has been demonstrated in several biomechanical studies. Performing the acetabular recession and evaluating the congruity of labral repairs during surgery is difficult with the application of traction distracting the femoral head from the chondrolabral junction. Additionally, prolonged traction risks nerve injury during hip arthroscopy. The purpose of this technique article is to describe a method of using traction only for central compartment work, and releasing the traction to allow the femoral head to reduce the labrum to its anatomic position for acetabular recession, anchor placement, and suture fixation. In this manner, the presented technique prevents an "out-of-round" or everted repair. This technique re-creates the native anatomy and biomechanics of the hip after acetabular recession and labral repair while decreasing traction time.
随着针对股骨髋臼撞击症的关节镜下盂唇修复技术的出现，髋关节镜检查的普及率呈指数级增长。关节镜下盂唇修复的目标是重新建立盂唇与股骨头之间的解剖学吸附密封。这种重要的解剖关系已在多项生物力学研究中得到证实。在手术过程中，应用牵引使股骨头与软骨盂唇交界处分离，难以进行髋臼后倾并评估盂唇修复的一致性。此外，长时间牵引存在髋关节镜检查期间神经损伤的风险。本文技术文章的目的是描述一种仅在中央间室操作时使用牵引，并释放牵引以使股骨头将盂唇复位至其解剖位置以进行髋臼后倾、锚钉置入和缝线固定的方法。通过这种方式，所介绍的技术可防止“不圆”或外翻修复。该技术在髋臼后倾和盂唇修复后重新建立髋关节的原始解剖结构和生物力学，同时减少牵引时间。
