Follet L, Khanduja V, Thevendran G, Ayeni O, Shanmugasundaram S, Abd El-Radi M, Said H, Abdelazeem A, Slullitel P, Marin-Peña O, Audenaert E
Department of Orthopedic Surgery and Traumatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK.
SICOT J. 2024;10:35. doi: 10.1051/sicotj/2024031. Epub 2024 Sep 19.
Hip arthroscopy is a rapidly evolving field in orthopedics, offering diagnostic and therapeutic benefits for a range of hip pathologies. This review outlines a comprehensive guide to initiating hip arthroscopy safely and effectively using evidence-based practices. Optimal surgical outcomes depend on correct indications for surgery, in particular in the presence of borderline dysplasia and degenerative joint diseases. Proper patient counseling and setting realistic expectations are crucial for satisfactory outcomes and recovery. Physical examination, radiographs, MRI, and CT scans are essential for accurate diagnosis. In case of diagnostic uncertainty, the use of intra-articular injections can help confirm the diagnosis before surgery. Techniques for hip arthroscopy include central compartment first, peripheral compartment first, and outside-in approaches. Each technique has advantages, and the optimal approach depends on the specific case. Finally, Proper operating room setup, meticulous patient positioning, and precise portal placement are critical for a successful procedure. A thorough understanding of the safe zone anatomy for portal placement is essential to minimize the risk of neurovascular complications. In conclusion, this manuscript provides a detailed, evidence-based framework for starting hip arthroscopy, emphasizing the importance of technical proficiency, patient selection, and a multidisciplinary approach to ensure patient safety and procedure efficacy.
髋关节镜检查是骨科领域中一个快速发展的领域，为一系列髋关节病变提供诊断和治疗益处。本综述概述了一份全面指南，介绍如何运用循证医学实践安全有效地开展髋关节镜检查。最佳手术效果取决于正确的手术指征，尤其是在存在临界发育不良和退行性关节疾病的情况下。对患者进行恰当的咨询并设定切合实际的期望，对于取得满意的手术效果和康复至关重要。体格检查、X线片、磁共振成像（MRI）和计算机断层扫描（CT）对于准确诊断必不可少。在诊断存在不确定性的情况下，关节内注射有助于在手术前确诊。髋关节镜检查技术包括先处理中央间室、先处理外周间室以及由外向内入路。每种技术都有其优势，最佳入路取决于具体病例。最后，合适的手术室设置、细致的患者体位摆放以及精确的入路点定位对于手术成功至关重要。深入了解入路点放置的安全区解剖结构对于将神经血管并发症的风险降至最低至关重要。总之，本文提供了一个详细的、基于循证医学的开展髋关节镜检查的框架，强调技术熟练程度、患者选择以及多学科方法对于确保患者安全和手术效果的重要性。
