Maldonado David R, Ortiz-Declet Victor, Chen Austin W, Lall Ajay C, Mohr Mitchell R, Laseter Joseph R, Domb Benjamin G
American Hip Institute, Westmont, Illinois, U.S.A.
Gotham City Orthopedics, New York, New York, U.S.A.
Arthrosc Tech. 2018 Jun 25;7(7):e779-e784. doi: 10.1016/j.eats.2018.03.015. eCollection 2018 Jul.
Hip dysplasia has been identified as one of the leading causes of osteoarthritis. However, hip arthroscopy alone, in the setting of hip dysplasia, remains controversial. In borderline hip dysplasia, with lateral center-edge angle (LCEA) between 18° and 25°, good outcomes have been reported with appropriate capsular and labral management. However, in severe hip dysplasia, with LCEA below 18°, there is an acetabular bony structural deficiency that must be addressed. Even with the potential benefit of hip arthroscopy in addressing intra-articular injuries related to the instability, it cannot be used for soft-tissue procedures. Periacetabular osteotomy remains the gold standard to address that matter; however, its invasive nature along with the long recovery time leaves some patients unwilling to undergo this procedure. New minimally invasive endoscopic procedures, derived from open techniques, describe acetabular autologous bone grafting as an alternative. Donor-side morbidity is always a concern when using autografts; we believe that the use of bone allograft will decrease this potential issue and make the procedure itself less invasive. This Technical Note will describe a type of endoscopic shelf acetabuloplasty using an allograft iliac bone graft.
髋关节发育不良已被确认为骨关节炎的主要病因之一。然而，对于髋关节发育不良患者，单纯进行髋关节镜检查仍存在争议。在边缘性髋关节发育不良中，外侧中心边缘角（LCEA）在18°至25°之间，据报道，通过适当的关节囊和盂唇处理可取得良好效果。然而，在严重髋关节发育不良中，LCEA低于18°，存在髋臼骨结构缺陷，必须加以解决。即使髋关节镜检查在处理与不稳定相关的关节内损伤方面具有潜在益处，但它不能用于软组织手术。髋臼周围截骨术仍然是解决这一问题的金标准；然而，其侵入性以及较长的恢复时间使一些患者不愿接受该手术。源自开放技术的新型微创内镜手术将髋臼自体骨移植描述为一种替代方法。使用自体骨时，供体部位的发病率始终是一个问题；我们认为，使用同种异体骨将减少这一潜在问题，并使手术本身的侵入性更小。本技术说明将描述一种使用同种异体髂骨移植的内镜架髋臼成形术。
