镜下关节囊紧缩缝合术治疗髋关节不稳△

Arthroscopic constrictive capsular suture for hip instability

摘要:

［目的］介绍髋关节囊紧缩术在髋关节不稳中的手术技术和初步结果。［方法］对本科 1 例髋关节不稳患者行关节镜下关节囊紧缩术。术中在髋关节镜监视下行关节探查，见盂唇完整，盂唇上方存在炎性改变，考虑为髋关节不稳导致，明确髋关节疼痛原因，随后退出至关节外，行关节镜下前外侧关节囊髂股韧带由外向内紧缩缝合术。［结果］患者手术顺利，无严重并发症。VAS 评分由术前的 6 分下降至术后 3 个月的 0 分，而 Harris 评分由 56 分提升至 90 分，iHOT12 评分由 60 分提升至 110 分。髋关节功能恢复良好。［结论］ 镜下髋关节囊紧缩术治疗髋关节不稳，具有手术创伤小、操作简单、手术并发症少的优点，近期效果满意。

Abstract:

[Objective] To introduce the surgical technique and preliminary clinical outcomes of arthroscopic constrictive capsular su- ture for hip instability. [Methods] One patient received arthroscopic constrictive capsular suture for hip instability. During the operation, ar- throscopic exploration revealed that the labrum was intact, and inflammatory changes were found above the labrum, which was considered to be caused by hip instability. As the cause of hip joint pain was determined, the anterior lateral joint capsule, involving iliofemoral liga- ment, was arthroscopically sutured with 3 stitches outside-in to constrict the hip. [Results] The patients had hip arthroscopy performed smoothly without serious complications. VAS score decreased from 6 preoperatively to 0 at 3 months postoperatively, while the Harris score increased from 56 to 90, and the iHOT12 score increased from 60 to 110. The patients got satisfactory functional recovery. [Conclusion] This arthroscopic constrictive capsular suture has benefits of minimal iatrogenic trauma, simple operation manipulation and few complica- tions, does achieve satisfactory preliminary outcome.