Shin Jason J, de Sa Darren L, Burnham Jeremy M, Mauro Craig S
Department of Orthopaedics and Sports Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15203, USA.
J Hip Preserv Surg. 2018 Jan 18;5(1):3-14. doi: 10.1093/jhps/hnx047. eCollection 2018 Jan.
With increased knowledge and understanding of hip pathology, hip arthroscopy is rapidly becoming a popular treatment option for young patients with hip pain. Despite improved clinical and radiographic outcomes with arthroscopic treatment, some patients may have ongoing pain and less than satisfactory outcomes. While the reasons leading to failed hip arthroscopy are multifactorial, patient selection, surgical technique and rehabilitation all play a role. Patients with failed hip arthroscopy should undergo a thorough history and physical examination, as well as indicated imaging. A treatment plan should then be developed based on pertinent findings from the workup and in conjunction with the patient. Depending on the etiology of failed hip arthroscopy, management may be nonsurgical or surgical, which may include revision arthroscopic or open surgery, periacetabular osteotomy or joint arthroplasty. Revision surgery may be appropriate in settings including, but not limited to, incompletely treated femoroacetabular impingement, postoperative adhesions, heterotopic ossification, instability, hip dysplasia or advanced degeneration.
随着对髋关节病理学知识的不断增加和理解，髋关节镜检查正迅速成为年轻髋关节疼痛患者的一种流行治疗选择。尽管关节镜治疗在临床和影像学方面的结果有所改善，但一些患者可能仍有持续疼痛且结果不尽人意。虽然导致髋关节镜检查失败的原因是多方面的，但患者选择、手术技术和康复都起到了一定作用。髋关节镜检查失败的患者应进行全面的病史和体格检查，以及必要的影像学检查。然后应根据检查的相关结果并结合患者情况制定治疗计划。根据髋关节镜检查失败的病因，治疗可能是非手术的或手术的，这可能包括翻修关节镜手术或开放手术、髋臼周围截骨术或关节置换术。翻修手术可能适用于包括但不限于以下情况：股骨髋臼撞击症治疗不彻底、术后粘连、异位骨化、不稳定、髋关节发育不良或晚期退变。
