Haase Lucas, Secretov Erwin, Nelson Grant, Raji Yazdan, Alexeev Mikhail, Salata Michael
University Hospitals of Cleveland, Cleveland, Ohio, U.S.A.
Sentara Healthcare, Harrisonburg, Virginia, U.S.A.
Arthrosc Tech. 2022 Jun 21;11(7):e1311-e1316. doi: 10.1016/j.eats.2022.03.015. eCollection 2022 Jul.
Hip arthroscopy is one of the most rapidly growing fields in orthopaedic surgery. One of the most frequent pathologies treated with hip arthroscopy remains femoroacetabular impingement, which is addressed by labral repair and femoral osteoplasty. The most commonly cited reason for failure of arthroscopic treatment of femoroacetabular impingement is under-resection of the cam lesion. Surgeons frequently use evaluations of preoperative images, intraoperative fluoroscopy, and dynamic range of motion to ensure adequate resection. In this article, we describe a reproducible and standardized technique to assist in appropriate resection. This is achieved by a 2-tiered resection technique: Tier 1 aims to set the depth of resection and restore the head-neck offset. Tier 2 then matches the depth of the resection set by tier 1 and allows for retention of appropriate transition of the proximal convexity to the distal concavity seen in more ideally shaped femoral heads. With this technique, we offer a tool to avoid under-resection in the area of maximal conflict while simultaneously minimizing the risk of proximal over-resection and thus compromising the fluid seal dynamics of the joint in deeper flexion angles.
髋关节镜检查是骨科手术中发展最为迅速的领域之一。髋关节镜治疗最常见的病理情况之一仍是股骨髋臼撞击症，可通过盂唇修复和股骨截骨术来解决。关节镜治疗股骨髋臼撞击症失败最常提及的原因是凸轮病变切除不充分。外科医生经常使用术前图像评估、术中透视和动态活动范围来确保充分切除。在本文中，我们描述了一种可重复且标准化的技术来辅助进行恰当切除。这通过一种两层切除技术来实现：第一层旨在设定切除深度并恢复头颈偏移。然后第二层与第一层设定的切除深度相匹配，并允许保留在形状更理想的股骨头中所见的近端凸度到远端凹度的适当过渡。通过这种技术，我们提供了一种工具，可避免在最大冲突区域切除不充分，同时将近端切除过多的风险降至最低，从而避免在更大屈曲角度时影响关节的液密封动力学。
