Hevesi Mario, Lee Dustin R, Wang Allen S, Krych Aaron J, Levy Bruce A
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Arthrosc Tech. 2023 Nov 6;12(12):e2111-e2116. doi: 10.1016/j.eats.2023.07.035. eCollection 2023 Dec.
Iliopsoas tendinitis following total hip arthroplasty has been linked to retroverted acetabular cup position with associated anterior overhang. For severely malpositioned components, preferred treatment is in the form of revision arthroplasty. However, for a substantial number of cases, iliopsoas tendinitis as well as associated pain and disability are observed in the presence of modest acetabular overhang. In such cases, patients may benefit substantially from arthroscopic iliopsoas fractional lengthening. Given altered postarthroplasty anatomy, we present an arthroscopic approach employing an iliopsoas air bursogram. In such a way, safe and predictable access can be provided for efficient tendon lengthening without capsular violation or inadvertent instrumentation of the nearby medial neurovascular bundle.
全髋关节置换术后髂腰肌肌腱炎与髋臼杯后倾位置及相关的前部悬垂有关。对于严重位置不当的假体组件，首选的治疗方法是翻修关节成形术。然而，在相当数量的病例中，在髋臼有适度悬垂的情况下，会观察到髂腰肌肌腱炎以及相关的疼痛和功能障碍。在这种情况下，患者可能会从关节镜下髂腰肌部分延长术中受益匪浅。考虑到关节置换术后解剖结构的改变，我们提出一种采用髂腰肌气囊造影的关节镜手术方法。通过这种方式，可以提供安全且可预测的入路，以有效地延长肌腱，而不会侵犯关节囊或意外损伤附近的内侧神经血管束。
