Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.
J Arthroplasty. 2022 Aug;37(8):1501-1504. doi: 10.1016/j.arth.2022.03.021. Epub 2022 Mar 11.
Musculotendinous deficiencies related to iliopsoas tendinitis and abductor mechanism disruption following total hip arthroplasty (THA) are frequently under diagnosed and can be frustrating to surgeons and devastating to patients with painful THAs with normal appearing radiographs. Current peer-reviewed evidence is presented for diagnosis and treatment options for these two musculotendinous deficiencies. While these musculotendinous deficiencies are treatable, prevention during the primary THA is ideal, and special attention should be taken into consideration for optimized acetabular cup size and position, optimized hip biomechanics, and preservation and protection of the abductor tendon insertion to the greater trochanter.
在全髋关节置换术(THA)后,与髂腰肌肌腱炎和外展肌机制紊乱相关的肌肉肌腱缺陷经常被漏诊,这对术者来说是令人沮丧的,对于影像学表现正常但疼痛的 THA 患者来说是灾难性的。目前提出了这两种肌肉肌腱缺陷的诊断和治疗选择的同行评议证据。虽然这些肌肉肌腱缺陷是可治疗的,但在初次 THA 期间进行预防是理想的,应特别注意优化髋臼杯的大小和位置、优化髋关节生物力学以及保护大转子上的外展肌腱附着点。