Bohnsack M
Klinik für Orthopädie und Unfallchirurgie, DIAKO Bremen, Gröpelinger Heerstr. 406-408, 28239, Bremen, Deutschland.
Oper Orthop Traumatol. 2018 Apr;30(2):87-97. doi: 10.1007/s00064-018-0538-8. Epub 2018 Mar 2.
Complete arthroscopic decompression of the impinging subspinal soft tissues and resection of the hypertrophic bone formation between the anterior hip capsule and the anterior inferior iliac spine (AIIS) or decompression of a hypertrophic AIIS.
Painful anterior hip impingement and decreased hip flexion following a hypertrophic osseous subspinal deformation.
No clinical symptoms or decreased anterior hip function despite radiological osseous subspinal hip impingement.
Hip arthroscopy in supine position on an extension table. Treatment of possible intraarticular hip pathologies in the central or peripheral compartment. Arthroscopic visualization of the hypertrophic impinging soft tissues below the AIIS and decompression using a shaver or radiofrequency device. Complete arthroscopic resection of the hypertrophic AIIS parts and the osseous subspinal deformation using a high speed burr under fluoroscopic control.
Early functional rehabilitation with full weight-bearing and unlimited hip motion; 3 weeks ossification prophylaxis and 8 weeks of limitation for jumping and running sports activities.
There are no comparative studies or medium- and long-term study results in the literature for arthroscopic AIIS decompression. However, currently published case series show an improvement of the determined scores.
对撞击性脊柱下软组织进行完全关节镜减压，并切除髋关节前囊与髂前下棘（AIIS）之间的肥厚性骨形成，或对肥厚的AIIS进行减压。
脊柱下骨肥厚变形后出现疼痛性髋关节前撞击和髋关节屈曲度降低。
尽管影像学检查显示有脊柱下髋关节撞击，但无临床症状或髋关节前功能未减退。
在伸展台上仰卧位进行髋关节镜检查。治疗中央或周围间隙可能存在的髋关节内病变。关节镜观察AIIS下方肥厚的撞击性软组织，并用刨削器或射频设备进行减压。在荧光透视控制下，用高速磨钻对肥厚的AIIS部分和脊柱下骨变形进行完全关节镜切除。
早期进行功能康复，完全负重，髋关节活动不受限；预防骨化3周，限制跳跃和跑步等体育活动8周。
文献中没有关于关节镜下AIIS减压的对照研究或中长期研究结果。然而，目前发表的病例系列显示所测定的评分有所改善。
