Tian Kang, Gao Guanying, Dong Hanmei, Zhang Siqi, Zhang Weiguo, Wang Jianquan, Xu Yan
Department of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.
Department of Sports Medicine, First Affiliated Hospital, Dalian Medical University, Dalian, China.
Arthrosc Tech. 2023 Jan 18;12(2):e307-e312. doi: 10.1016/j.eats.2022.11.008. eCollection 2023 Feb.
With the increasing popularity of hip arthroscopy, postoperative iatrogenic instability due to bony and soft-tissue issues has been noted by more orthopaedic surgeons. Although there is a low risk of serious complications in patients with normal hip joint development even without suturing of the joint capsule, for patients with a preoperative high risk of anterior instability-including those with excessive anteversion of the acetabulum or femur, borderline dysplasia of the hip, and hip arthroscopic revision surgery with an anterior defect of the joint capsule-capsulotomy without repair will result in postoperative anterior instability of the hip joint and related symptoms. Capsular suturing techniques that provide anterior stabilization will be of great help for these high-risk patients and reduce the possibility of postoperative anterior instability. In this Technical Note, we introduce the arthroscopic capsular suture-lifting technique for treating femoroacetabular impingement (FAI) patients with a high risk of postoperative hip instability. In the past 2 years, the capsular suture-lifting technique has been used to treat FAI patients with borderline dysplasia of the hip and excessive femoral neck anteversion, and clinical results have shown that the suture-lifting technique provides a reliable and effective solution for FAI patients with a high risk of postoperative anterior hip instability.
随着髋关节镜检查的日益普及,骨科医生越来越多地注意到因骨和软组织问题导致的术后医源性不稳定。尽管即使不缝合关节囊,髋关节发育正常的患者出现严重并发症的风险也很低,但对于术前存在前侧不稳定高风险的患者,包括髋臼或股骨过度前倾、髋关节临界发育不良以及关节囊前部有缺损的髋关节镜翻修手术患者,不进行修复的关节囊切开术会导致术后髋关节前侧不稳定及相关症状。提供前侧稳定作用的关节囊缝合技术将对这些高风险患者有很大帮助,并降低术后前侧不稳定的可能性。在本技术说明中,我们介绍用于治疗术后髋关节不稳定高风险的股骨髋臼撞击症(FAI)患者的关节镜下关节囊缝合提升技术。在过去两年中,关节囊缝合提升技术已用于治疗髋关节临界发育不良和股骨颈过度前倾的FAI患者,临床结果表明,缝合提升技术为术后髋关节前侧不稳定高风险的FAI患者提供了可靠有效的解决方案。