Maldonado David R, Chen Jeffrey W, Walker-Santiago Rafael, Rosinsky Philip J, Shapira Jacob, Lall Ajay C, Domb Benjamin G
American Hip Institute, Westmont, Illinois, U.S.A.
Arthrosc Tech. 2019 May 17;8(6):e575-e584. doi: 10.1016/j.eats.2019.01.017. eCollection 2019 Jun.
Most surgeons rely on the greater trochanter as the reference point to establish the anterolateral portal. Nevertheless, we believe that the anterosuperior iliac spine is a more reliable landmark. Unlike the greater trochanter, it is unaffected by leg rotation and is more easily identified by palpation. Abiding by the central tenet of medicine to "do no harm," the technique described herein presents in detail the concept of the 12 o'clock portal placement, a hip joint access method based on identifying specific anatomic points under fluoroscopy and by palpation. To accomplish this goal, this Technical Note presents a step-by-step approach, including tips and pearls for patient positioning and fluoroscopic guidance. We believe this method ensures a reproducible and safe way to start hip arthroscopy in the supine position.
大多数外科医生依靠大转子作为建立前外侧入路的参考点。然而，我们认为髂前上棘是一个更可靠的标志。与大转子不同，它不受腿部旋转的影响，并且通过触诊更容易识别。遵循医学的核心原则“不伤害”，本文所述技术详细介绍了12点入路放置的概念，这是一种基于在荧光透视下和通过触诊识别特定解剖点的髋关节进入方法。为实现这一目标，本技术说明提供了一种循序渐进的方法，包括患者体位摆放和荧光透视引导的技巧和要点。我们相信这种方法确保了一种可重复且安全的在仰卧位开始髋关节镜检查的方式。
