Salas Antonio Porthos, Mazek Jacek, María Andrew Carlo, Taffinder David Santiago, Velasco-Vazquez Hector
Hip Arthroscopy Mexico, San Pedro Garza Garcia, Nuevo Leon, Mexico.
Arthrosc Tech. 2023 May 11;12(6):e867-e871. doi: 10.1016/j.eats.2023.02.020. eCollection 2023 Jun.
Hip arthroscopic treatment for femoroacetabular impingement syndrome and labral tears is the gold standard in the adult and adolescent population, as we all know the most common surgical approach to the hip is entering the central compartment with fluoroscopy and with continuous distraction. A periportal capsulotomy in traction must be done to have visibility and instrument maneuverability. These maneuvers avoid scuffing the femoral head cartilage. In adolescents, extreme care must be taken in hip distraction, as the force used can cause iatrogenic neurovascular lesions, avascular necrosis, and lacerations of the genitals and foot/ankle. Experienced surgeons around the world have developed an extracapsular approach to the hip with smaller capsulotomies with a low complication rate. This approach to the hip has brought attention in the adolescent population because it is more secure and simple. Less force of distraction is needed because the capsulotomy is done first. This surgical technique allows observation of the cam morphology while entering to the hip without distraction. We describe an extracapsular approach as an option to treat femoral acetabular impingement syndrome and labral tears in the pediatric and adolescent population.
髋关节镜治疗股骨髋臼撞击综合征和盂唇撕裂是成人和青少年群体的金标准，众所周知，髋关节最常见的手术入路是在透视引导下持续牵引进入中央腔隙。必须进行带牵引的经门静脉关节囊切开术，以获得视野和器械操作空间。这些操作可避免擦伤股骨头软骨。在青少年中，髋关节牵引时必须格外小心，因为所用的力量可能导致医源性神经血管损伤、缺血性坏死以及生殖器和足部/踝部撕裂伤。世界各地的经验丰富的外科医生已经开发出一种髋关节囊外入路，关节囊切开较小，并发症发生率较低。这种髋关节入路在青少年群体中引起了关注，因为它更安全、简单。由于首先进行关节囊切开术，所需的牵引力量较小。这种手术技术允许在不牵引的情况下进入髋关节时观察凸轮形态。我们描述一种囊外入路作为治疗儿童和青少年群体股骨髋臼撞击综合征和盂唇撕裂的一种选择。
