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髋关节镜检查治疗股骨髋臼撞击症时“颈上入路”的手术技术

Surgical Technique of the "Up-The-Neck" View During Hip Arthroscopy for Femoroacetabular Impingement.

作者信息

Mengers Sunita R, Strony John T, Vakharia Ajit, Su Charles A, Edwards Gary, Salata Michael J

机构信息

Department of Orthopaedic Surgery, Cleveland, Ohio, U.S.A.

University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A.

出版信息

Arthrosc Tech. 2022 Apr 25;11(5):e923-e928. doi: 10.1016/j.eats.2022.01.011. eCollection 2022 May.

Abstract

In the setting of femoroacetabular impingement, arthroscopy versus open surgery confers many advantages. However, inadequate bony resection remains a concern and is the leading cause of revision surgery. Several strategies have been described to ensure a more-complete resection during hip arthroscopy. In this current technique article, the authors describe a modified anterior portal site view called the "up-the-neck" view. This view allows for greater visualization of the femoral head-neck junction and alleviates challenges faced when assessing resection intraoperatively. The "up-the-neck" view is achieved by placing a 70° arthroscope in the anterior lateral portal and subsequently rotating the camera 90°. The head-neck junction will appear horizontally, rather than vertically, on this view, which allows for the easy identification of missed imperfections. This may reduce the need for revision surgery and future investigation is necessary to determine the reoperation rates following this technique.

摘要

在股骨髋臼撞击症的情况下,关节镜手术与开放手术相比具有许多优势。然而,骨切除不充分仍然是一个问题,并且是翻修手术的主要原因。已经描述了几种策略以确保在髋关节镜检查期间进行更完整的切除。在这篇当前的技术文章中,作者描述了一种改良的前入路视野,称为“沿颈向上”视野。这种视野可以更好地观察股骨头颈交界处,并减轻术中评估切除时面临的挑战。“沿颈向上”视野是通过将70°关节镜置于前外侧入路并随后将摄像头旋转90°来实现的。在此视野下,头颈交界处将呈水平而非垂直显示,这便于轻松识别遗漏的不完美之处。这可能会减少翻修手术的需求,并且需要进一步的研究来确定采用该技术后的再次手术率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c95f/9134677/597f43f27193/gr1.jpg

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