Woyski Dustin, Mather Richard Chad
Department of Orthopaedic Surgery, Duke University Medical Center, Box 3000, Durham, NC, 27705, USA.
Curr Rev Musculoskelet Med. 2019 Sep;12(3):291-299. doi: 10.1007/s12178-019-09575-1.
With the rapid growth of hip arthroscopy over the past decade, new treatment paradigms as well as recognition of new disease states have sprung forth. The ability to perform complex arthroscopic procedures of the hip such as labral augmentation and reconstruction is essential for hip arthroscopists in the revision setting, with patient selection and indications for various labral treatments the key driver for improved short- and mid-term clinical outcomes.
Current techniques have been developed to address disease states where the labrum is either unstable, torn, deficient, or otherwise incompetent. Many early reports focused on the description of these techniques with new literature reporting short- and mid-term outcomes. A few of these have demonstrated improved outcomes with a contemporary arthroscopy with emphasis on capsule preservation and repair. Studies have demonstrated that labral repair has improved outcomes over labral debridement, with results of labral reconstruction in a revision approaching those of labral repair. In addition, newer reports have shown significantly improved outcomes and survivorship with capsule repair and therefore should be included in every hip arthroscopy.
在过去十年中,随着髋关节镜检查的迅速发展,新的治疗模式以及对新疾病状态的认识不断涌现。对于髋关节镜检查医生而言,在翻修手术中能够进行复杂的髋关节镜手术,如盂唇增强和重建,至关重要,而患者选择和各种盂唇治疗的适应症是改善短期和中期临床结果的关键驱动因素。
目前已开发出针对盂唇不稳定、撕裂、缺损或其他功能不全等疾病状态的技术。许多早期报告专注于这些技术的描述,新文献则报告了短期和中期结果。其中一些报告显示,当代关节镜检查强调保留和修复关节囊,其结果有所改善。研究表明,盂唇修复的效果优于盂唇清创,翻修手术中盂唇重建的结果接近盂唇修复。此外,最新报告显示,关节囊修复的结果和生存率显著改善,因此应纳入每例髋关节镜检查中。