Lin Zhuohua, Cui Ligang, Xu Yan, Fu Qiang, Sun Youjing
Department of Ultrasound, Peking University Third Hospital, 49 Huayuan N Rd, Haidian District, Beijing 100191, China.
Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, 49 North Garden Road, Beijing 100191, China.
J Hip Preserv Surg. 2024 Apr 11;11(3):204-209. doi: 10.1093/jhps/hnad050. eCollection 2024 Jul.
This study aimed to evaluate the feasibility of using ultrasound for monitoring osteochondroplasty intraoperatively, determine the factors that interfere with ultrasound imaging and assess its influence on surgeon performance. Intraoperative ultrasonography was performed during osteochondroplasty in 39 cases of arthroscopy. The femoral head-neck junction (FHNJ) was evaluated using ultrasonography. Another 39 cases, which underwent conventional arthroscopy, were included in the control group. The C-arm was used in this group at the end of osteochondroplasty to confirm that no residual cam lesion remained. Pre- and postoperative Dunn radiographs and computed tomography (CT) scans were analyzed to determine the feasibility of ultrasound. Residual cam deformity was noted in eight cases under ultrasound. The FHNJ was not detected owing to ultrasound interference by air in three cases. No difference in the angle measured in Dunn radiographs and the residual cam deformity rate of CT at the 1:00, 2:00 or 3:00 position was found between both groups. However, the angle at the 3:00 position was greater in the ultrasound group than in the control group (44.4 ± 4.3° versus 41.3 ± 5.1°, < 0.05), suggesting that more bone was preserved at 3:00 in the ultrasound group. No difference was found in the mean operation time. None of the patients experienced complications, such as wounds or intra-articular infections. Ultrasound is a safe method for assessing FHNJ during arthroscopy. It did not change the risk of residual cam deformity but positively affected the surgeon's performance by reducing unnecessary bone removal.
本研究旨在评估术中使用超声监测骨软骨成形术的可行性,确定干扰超声成像的因素,并评估其对外科医生操作的影响。对39例关节镜检查的骨软骨成形术患者进行了术中超声检查。使用超声评估股骨头-颈交界处(FHNJ)。对照组纳入另外39例行传统关节镜检查的患者。该组在骨软骨成形术结束时使用C形臂确认无残留凸轮病变。分析术前和术后的邓氏X线片和计算机断层扫描(CT)以确定超声的可行性。超声检查发现8例有残留凸轮畸形。3例因空气干扰超声未检测到FHNJ。两组在邓氏X线片测量的角度以及CT在1:00、2:00或3:00位置的残留凸轮畸形率方面均未发现差异。然而,超声组在3:00位置的角度大于对照组(44.4±4.3°对41.3±5.1°,<0.05),表明超声组在3:00位置保留了更多骨质。平均手术时间无差异。所有患者均未出现伤口或关节内感染等并发症。超声是关节镜检查期间评估FHNJ的一种安全方法。它不会改变残留凸轮畸形的风险,但通过减少不必要的骨质切除对外科医生的操作产生了积极影响。