Tjong Vehniah K
Arthroscopy. 2024 Nov;40(11):2704-2705. doi: 10.1016/j.arthro.2024.03.015. Epub 2024 Mar 16.
Hip capsular preservation remains most common in the United States despite literature to-date showing varying outcomes. Different surgeons prefer, and different patients require, periportal capsulotomies versus wider exposure with T-type capsulotomy and traction stitches. In addition to revision cases, some hip phenotypes may require more aggressive capsular management. Patients with borderline hip dysplasia, acetabular retroversion, increased femoral anteversion, and greater Beighton scores necessitate more hip stability; thus, capsular preservation and closure is essential. However, patients with "tight" hips, thicker capsules, and larger cam deformities may require less-stringent capsular care. Regardless, adequate bony decompression is paramount in patients with femoroacetabular impingment syndrome.
在美国,保留髋关节囊仍然最为常见,尽管迄今为止的文献显示结果各异。不同的外科医生有不同偏好,不同的患者也有不同需求,有的需要进行门静脉周围关节囊切开术,有的则需要通过T型关节囊切开术和牵引缝线获得更广泛的暴露。除了翻修病例外,一些髋关节表型可能需要更积极的关节囊处理。髋关节发育不良临界、髋臼后倾、股骨前倾角增加以及贝ighton评分较高的患者需要更强的髋关节稳定性;因此,保留并闭合关节囊至关重要。然而,髋关节“紧绷”、关节囊较厚以及凸轮畸形较大的患者可能需要不那么严格的关节囊处理。无论如何,对于股骨髋臼撞击综合征患者,充分的骨质减压至关重要。