Kim S J, Choi N H, Kim H J
Department of Orthopaedic Surgery, Yonsei University Medical College, Seoul, Korea.
Clin Orthop Relat Res. 1998 Aug(353):156-65. doi: 10.1097/00003086-199808000-00018.
Twenty patients underwent operative arthroscopic procedures of the hip joint. All procedures were performed with the patient in the supine position on a standard fracture table using fluoroscopy through three arthroscopic portals (anterolateral, anterior paratrochanteric, and posterior paratrochanteric). The initial indications were therapeutic in 16 patients: loose bodies in four, synovial chondromatosis in three, rheumatoid arthritis in five, ankylosing spondylitis in one, septic arthritis in one, avascular necrosis of femoral head in one, and primary osteoarthritis in one. In four patients who had unexplained hip pain, the initial indications were diagnostic: minimal synovial change was seen in two patients, a synovial chondromatosis was present in another, and a tear of the acetabular labrum and hypertrophy of ligament teres were present in a fourth patient. In one patient who had primary osteoarthritis, the insertion of the arthroscopic instrument into the hip joint failed because of profuse osteophytes along the acetabular rim. Twelve of the 19 patients showed significant improvement of the symptoms after the arthroscopic procedure, but seven patients had no benefit from the procedure. One patient had a postoperative reflex sympathetic dystrophy.
20例患者接受了髋关节镜手术。所有手术均在标准骨折手术台上患者仰卧位进行，通过三个关节镜入口（前外侧、转子前和转子后）使用荧光透视。最初的适应证中，16例为治疗性：4例为游离体，3例为滑膜软骨瘤病，5例为类风湿关节炎，1例为强直性脊柱炎，1例为化脓性关节炎，1例为股骨头缺血性坏死，1例为原发性骨关节炎。4例不明原因髋关节疼痛患者，最初的适应证为诊断性：2例可见轻微滑膜改变，另1例存在滑膜软骨瘤病，第4例存在髋臼唇撕裂和圆韧带肥大。1例原发性骨关节炎患者，由于髋臼边缘大量骨赘，关节镜器械无法插入髋关节。19例患者中有12例在关节镜手术后症状明显改善，但7例患者未从手术中获益。1例患者术后发生反射性交感神经营养不良。
