髂腰肌切断术后全髋关节置换术在脊柱骨盆失平衡中的前脱位：一例罕见病例报告
Anterior dislocation of THA after Iliopsoas tenotomy in spinopelvic imbalance: a rare case report.
作者信息
Yoon Sun-Jung, Ko Jong-Hyun, Matsuda Dean K
机构信息
Department of Orthopedic Surgery, Research Institute of Clinical Medicine, Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Gunji-ro 20, Dukjin-gu, Jeonju, Jeonbuk, 54907, Republic of Korea.
Premier Hip Arthroscopy, Marina Del Rey, CA, USA.
出版信息
BMC Musculoskelet Disord. 2020 Nov 7;21(1):723. doi: 10.1186/s12891-020-03711-6.
BACKGROUND
Iliopsoas impingement is a complication of total hip arthroplasty that often manifests as groin pain during initial hip flexion. However, there are no reports of mechanical complications after iliopsoas tenotomy following total hip arthroplasty (THA).
CASE PRESENTATION
We present the case of a 64-year-old woman with degenerative lumbar kyphosis who developed anterior hip dislocations after arthroscopic iliopsoas tenotomy for anterior impingement following THA. She ultimately required revision of the acetabular cup.
CONCLUSIONS
Arthroscopic tenotomy for refractory iliopsoas tendinopathy may be appealing because of its less invasive nature. However, caution should be exercised in the setting of significant cup malpositioning and/or spinopelvic imbalance to avoid iatrogenic anterior instability.
背景
髂腰肌撞击是全髋关节置换术的一种并发症，常表现为髋关节初始屈曲时腹股沟区疼痛。然而，全髋关节置换术（THA）后髂腰肌切断术后机械性并发症尚无报道。
病例报告
我们报告一例64岁患有退行性腰椎后凸畸形的女性患者，在THA后因前撞击行关节镜下髂腰肌切断术后发生前髋关节脱位。她最终需要翻修髋臼杯。
结论
关节镜下切断术治疗难治性髂腰肌肌腱病因其侵入性较小可能具有吸引力。然而，在髋臼杯严重位置不良和/或脊柱骨盆失衡的情况下应谨慎操作，以避免医源性前向不稳定。
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