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小儿髋关节镜检查:适应证及治疗结果综述

Pediatric Hip Arthroscopy: a Review of Indications and Treatment Outcomes.

作者信息

Crofts Helen, McConkey Mark, Lodhia Parth

机构信息

Department of Orthopaedics, University of British Columbia, Vancouver, Canada.

Vancouver Hip Institute, Vancouver, Canada.

出版信息

Curr Rev Musculoskelet Med. 2023 Jul;16(7):284-294. doi: 10.1007/s12178-023-09842-2. Epub 2023 May 31.

Abstract

PURPOSE OF REVIEW

The use of hip arthroscopy has expanded substantially over the last decade, including in pediatric and adolescent populations. Indications for hip arthroscopy in the pediatric population continue to be refined and research of outcomes following hip arthroscopy has increased. The purpose of this review is to provide an overview of current indications for hip arthroscopy in the pediatric population and the outcomes for each indication.

RECENT FINDINGS

Hip arthroscopy is used in the treatment of a range of pediatric hip conditions, spanning from the infant to young adult. In femoroacetabular impingement, hip arthroscopy in young adolescents has shown improvement in patient-reported outcome measures, high return to sport rates, and low complications. Intra-articular hip pathology secondary to Legg-Calve-Perthes and the persistent deformities following slipped capital femoral epiphysis can be managed with primary hip arthroscopy, and outcomes show significant improvements in patient-reported outcomes. Arthroscopy can be used safely as a reduction aid in developmental hip dysplasia, and as a primary treatment for borderline hip dysplasia in adolescents. In septic hip arthritis, arthroscopic drainage is a safe and effective treatment. Hip arthroscopy is used in the pediatric and adolescent population in the management of femoroacetabular impingement, Legg-Calve-Perthes disease, the sequelae of slipped capital femoral epiphysies, developmental hip dysplasia, and septic arthritis. Research for each of these conditions shows that arthroscopy is a safe and effective treatment when performed for the correct indications, and results are comparable to open surgical options.

摘要

综述目的

在过去十年中,髋关节镜检查的应用已大幅扩展,包括在儿童和青少年人群中。儿童髋关节镜检查的适应证仍在不断完善,对髋关节镜检查后结果的研究也有所增加。本综述的目的是概述儿童髋关节镜检查的当前适应证以及每种适应证的结果。

最新发现

髋关节镜检查用于治疗一系列儿童髋关节疾病,涵盖从婴儿到青年成人。在股骨髋臼撞击症中,青少年髋关节镜检查在患者报告的结局指标方面显示出改善,运动恢复率高且并发症少。对于Legg-Calve-Perthes病继发的关节内髋关节病变以及股骨头骨骺滑脱后的持续性畸形,可采用初次髋关节镜检查进行处理,结果显示患者报告的结局有显著改善。关节镜检查可安全地用作发育性髋关节发育不良的复位辅助手段,并作为青少年临界髋关节发育不良的主要治疗方法。在化脓性髋关节炎中,关节镜下引流是一种安全有效的治疗方法。髋关节镜检查用于儿童和青少年人群中股骨髋臼撞击症、Legg-Calve-Perthes病、股骨头骨骺滑脱后遗症、发育性髋关节发育不良和化脓性关节炎的治疗。对这些疾病中的每一种进行的研究表明,当适应证正确时,关节镜检查是一种安全有效的治疗方法,其结果与开放手术选择相当。

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