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分步式仰卧位髋关节镜安全入路:从 A 到 Z 的技巧和要点。

Stepwise Safe Access in Hip Arthroscopy in the Supine Position: Tips and Pearls From A to Z.

机构信息

From American Hip Institute Research Foundation (Dr. Maldonado, Dr. Rosinsky, Dr. Shapira, and Dr. Domb), and American Hip Institute (Dr. Domb), Des Plaines, IL.

出版信息

J Am Acad Orthop Surg. 2020 Aug 15;28(16):651-659. doi: 10.5435/JAAOS-D-19-00856.

Abstract

Hip arthroscopy is rapidly growing as a treatment with good outcomes for pathologic conditions such as femoroacetabular impingement syndrome and labral tears. At the same time, it is one of the most technically challenging and demanding procedures in orthopaedics with a technically demanding skill. The first challenge is to safely access the joint, which requires accurate anatomical knowledge, a strong sense of spatial orientation, and repeated practice. Iatrogenic chondrolabral injury has been reported as the most common complication in hip arthroscopy and most frequently occurs during hip joint access. As such, basic foundations cannot be overstated. These complications can be minimized with adequate patient positioning, reproducible hip joint access techniques, and proper portals placement. Nonetheless, these three points are perhaps the greatest hurdles that orthopaedic surgeons face when entering the hip arthroscopy field. In this review, we outlined a stepwise approach for a safe access to hip arthroscopy.

摘要

髋关节镜检查作为一种治疗方法,在治疗股骨髋臼撞击综合征和盂唇撕裂等病理状况方面具有良好的效果,发展迅速。与此同时,它也是骨科中技术要求最高、难度最大的手术之一,需要高超的技术。第一个挑战是安全地进入关节,这需要准确的解剖学知识、强烈的空间定向感和反复的练习。医源性软骨-盂唇损伤是髋关节镜检查中最常见的并发症,最常发生在髋关节进入时。因此,基础至关重要。通过适当的患者体位、可重复的髋关节进入技术和正确的入路放置,可以最大限度地减少这些并发症。尽管如此,这三点可能是骨科医生进入髋关节镜领域时面临的最大障碍。在这篇综述中,我们概述了一种安全进入髋关节镜检查的分步方法。

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