Simon Karissa N, Holliday Charles, Krych Aaron J, Hevesi Mario
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Arthrosc Tech. 2024 Jun 14;13(10):103074. doi: 10.1016/j.eats.2024.103074. eCollection 2024 Oct.
In the standard approach to hip arthroscopy, access to the joint is achieved using fluoroscopic guidance to enter the central compartment of the hip using the Seldinger technique, penetrating the capsule with a needle and subsequently cannulating and obtaining direct visualization of the joint. In such a way, arthroscopists then proceed with accessory portal creation and capsulotomy, as desired, under direct intra-articular visualization. In cases with severe pincer morphology or coxa profunda, it may not be possible to safely access the central compartment under fluoroscopic guidance due to significant lateral overcoverage of the femoral head. We present an outside-in arthroscopic approach for accessing the hip joint in such patients, allowing for safe visualization, osseous pincer resection, and improved central compartment access while minimizing the risk to cartilage and labral tissue.
在髋关节镜检查的标准方法中，通过透视引导使用Seldinger技术进入髋关节中央腔，用针穿透关节囊，随后置入套管并直接观察关节，从而进入关节。通过这种方式，关节镜医师随后根据需要在关节内直视下进行辅助入口创建和关节囊切开术。在严重钳夹形态或髋臼过深的病例中，由于股骨头明显的外侧覆盖，在透视引导下可能无法安全进入中央腔。我们提出了一种针对此类患者的由外向内的关节镜入路方法，可实现安全观察、骨钳夹切除，并改善中央腔的进入，同时将对软骨和盂唇组织的风险降至最低。
