Lall Ajay C, Schwarzman Garrett R, Battaglia Muriel R, Chen Sarah L, Maldonado David R, Domb Benjamin G
American Hip Institute, Des Plaines, Illinois, U.S.A.
University of Illinois, Chicago, Illinois, U.S.A.
Arthrosc Tech. 2019 Aug 1;8(8):e889-e903. doi: 10.1016/j.eats.2019.04.004. eCollection 2019 Aug.
Over the past decade, understanding of disorders compromising greater trochanteric pain syndrome (GTPS) has increased dramatically. Nonsurgical treatment options include physical rehabilitation and activity modification, anti-inflammatory as well as biologic injections into the peritrochanteric compartment, and administration of oral analgesics. Multiple open and endoscopic treatment options exist when nonsurgical management is unsuccessful in patients with refractory lateral-sided hip pain, with or without weakness. No true consensus exists within the literature regarding operative techniques of GTPS or postoperative rehabilitation protocols. We present an endoscopic classification system of GTPS with 5 distinct types, which seems to correlate well with preoperative diagnoses and postoperative rehabilitation protocols. The classification system is intuitive, and the corresponding surgical techniques are reproducible for surgeons treating peritrochanteric pathology. Level of Evidence: I (hip); II (extra-articular, impingement).
在过去十年中,对影响大转子疼痛综合征(GTPS)的疾病的认识有了显著提高。非手术治疗选择包括物理康复和活动调整、向转子周围间隙注射抗炎药和生物制剂,以及口服镇痛药。对于难治性外侧髋关节疼痛(无论有无无力症状)的患者,若非手术治疗失败,则有多种开放手术和内镜治疗选择。关于GTPS的手术技术或术后康复方案,文献中尚无真正的共识。我们提出了一种GTPS的内镜分类系统,该系统有5种不同类型,似乎与术前诊断和术后康复方案有很好的相关性。该分类系统直观易懂,相应的手术技术对于治疗转子周围病变的外科医生来说是可重复的。证据水平:I(髋关节);II(关节外,撞击)。