Lall Ajay C, Ankem Hari K, Diulus Samantha C, Maldonado David R, Meghpara Mitchell B, Rosinsky Philip J, Shapira Jacob, Domb Benjamin G
American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.
American Hip Institute, Chicago, Illinois, U.S.A.
Arthrosc Tech. 2021 Jan 18;10(2):e587-e597. doi: 10.1016/j.eats.2020.10.045. eCollection 2021 Feb.
Treatment of hip joint chondral damage is a well-recognized aspect of the arthroscopic management of femoroacetabular impingement syndrome. Hip chondral resurfacing has evolved from microfracture to different forms of cartilage grafting, all with variable long-term outcomes. Recent literature has focused on techniques using different cartilage sources (native and synthetic products) that are available for clinicians to choose from during hip arthroscopy. None of the published reports on cartilage grafts have commented on hip joint capsular management as part of the procedure. This is likely because of the increased difficulty of capsular closure in the dry arthroscopic environment required for graft stabilization. However, potential iatrogenic hip instability induced by an unrepaired interportal capsulotomy can be detrimental to the existing joint architecture and possibly to the cartilage graft. This article presents a step-by-step approach, including tips and pearls, for capsular closure during arthroscopic acetabular chondral resurfacing with BioCartilage (Arthrex, Naples, FL). This method is a safe and reproducible way to close the joint capsule during chondral resurfacing in patients undergoing hip preservation that can potentially enhance the chances of a successful outcome.
髋关节软骨损伤的治疗是股骨髋臼撞击综合征关节镜治疗中一个公认的方面。髋关节软骨表面修复已从微骨折发展到不同形式的软骨移植，所有这些方法的长期效果各不相同。最近的文献集中在使用不同软骨来源（天然和合成产品）的技术上，这些技术可供临床医生在髋关节镜检查期间选择。关于软骨移植的已发表报告均未将髋关节囊管理作为手术的一部分进行评论。这可能是因为在移植稳定所需的干燥关节镜环境中，关节囊闭合的难度增加。然而，未修复的关节镜检查入口间关节囊切开术引起的潜在医源性髋关节不稳定可能对现有关节结构以及可能对软骨移植有害。本文介绍了一种在使用生物软骨（Arthrex，那不勒斯，佛罗里达州）进行关节镜下髋臼软骨表面修复期间进行关节囊闭合的分步方法，包括提示和技巧。这种方法是在接受髋关节保留手术的患者进行软骨表面修复期间关闭关节囊的一种安全且可重复的方法，有可能提高成功结果的几率。
