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髋关节镜术后关节囊周围瘢痕形成的麻醉下髋关节手法治疗:适应证与技术

Hip Manipulation Under Anesthesia for Post-Hip Arthroscopy Pericapsular Scarring: Indications and Techniques.

作者信息

Gaio Natalie M, Turner Elizabeth H G, Spiker Andrea M

机构信息

Department of Orthopedic Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.

Department of Orthopedic Surgery, Henry Ford Hospital, Detroit, Michigan, U.S.A.

出版信息

Arthrosc Tech. 2023 May 29;12(6):e983-e989. doi: 10.1016/j.eats.2023.02.036. eCollection 2023 Jun.

Abstract

Hip arthroscopy has become an increasingly common procedure with expanding indications over the last several decades. With the increase in number of procedures performed a complication profile has emerged, although there is yet to be a formal classification system for complications. The most cited complications include lateral femoral cutaneous nerve neuropraxia, other sensory deficits, chondral or labral iatrogenic damage, superficial infection and deep vein thrombosis. One complication that has not yet been well documented in the literature is pericapsular scarring/adhesions resulting in decreased hip range of motion and function. If this complication is noted to persist after adequate impingement resection and a rigorous post-operative physical therapy regimen, the senior author has addressed this with a hip manipulation under anesthesia. Therefore, this techniques paper aims to describe pericapsular scarring as a post hip-arthroscopy condition which may cause pain and demonstrate our technique to address this diagnosis through hip manipulation under anesthesia.

摘要

在过去几十年里,随着适应证的不断扩大,髋关节镜检查已成为一种越来越常见的手术。随着手术数量的增加,并发症情况逐渐显现,尽管目前尚无针对并发症的正式分类系统。最常被提及的并发症包括股外侧皮神经失用症、其他感觉缺陷、软骨或盂唇医源性损伤、浅表感染和深静脉血栓形成。文献中尚未充分记载的一种并发症是关节囊周围瘢痕形成/粘连,导致髋关节活动范围和功能下降。如果在充分的撞击切除和严格的术后物理治疗方案后,发现这种并发症仍然存在,资深作者会在麻醉下进行髋关节手法操作来处理。因此,本技术论文旨在描述关节囊周围瘢痕形成作为髋关节镜检查后的一种状况,它可能会引起疼痛,并展示我们通过麻醉下髋关节手法操作来诊断和处理这种情况的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d2f/10323974/b206dbd687e4/gr1.jpg

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