保留髂股韧带的关节囊纵切在关节镜手术中的应用  

Clinical application of longitudinal capsulotomy with iliofemoral ligament preserved in hip arthroscopy

作　　者：殷庆丰[1] 李岩 傅英强 赵恒[1] 刘文广[1] 王韶进[1] Yin Qingfeng;Li Yan;Fu Yingqiang;Zhao Heng;Liu Wenguang;Wang shaojin(Department of Orthopedics,The Second Hospital of Shandong University,Shandong University,Jinan 250033,China;Department of Orthopedics,Anqiu People’s hospital,Weifang 262199,China;Cheelo Medical School,Shandong University,Jinan 250012,China)

机构地区：[1]山东大学第二医院关节外科/运动医学科,济南250033 [2]安丘市人民医院骨关节外科,潍坊262199 [3]山东大学齐鲁医学院,济南250012

出　　处：《中华关节外科杂志（电子版）》2022年第2期231-235,共5页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的:介绍关节镜下保留髂股韧带的关节囊纵切技术,并汇报其初步临床结果。方法:回顾山东大学第二医院运动医学科2018年10月至2019年10月期间的髋关节镜手术病例。纳入病例都采用由外向内纵向关节囊切开技术进行髋关节镜手术,并完成至少6个月临床随访。统计患者的一般资料,以及关节囊切开操作时间,牵引时间,手术总时间,术中是否透视,关节囊是否闭合等手术指标,统计术后并发症发生率。比较术前和术后髋关节功能评分,采用独立样本t检验进行统计分析。结果:共纳入采用囊外纵切技术的髋关节镜手术病例62例,其中髋关节撞击症和临界发育不良引发的盂唇损伤病例共53例。采取关节纵切技术完成关节囊切开平均需要(12±4)min,手术中平均牵引的时间为(39±9)min,总手术时间为(127±15)min。30.6%的患者(19例)不需要术中透视定位辅助,72.6%的患者(45例)采用了关节囊闭合。无严重手术并发症,无再手术和翻修病例。术后6个月髋关节功能评分由术前的(45±10)分提高到术后的(77±9)分(t=17.889,P<0.001)。结论:采用髋关节囊外纵向切开技术,配合关节囊的闭合管理,能够较好的维护关节囊的完整性,具有良好的手术安全性和肯定的临床疗效。Objective:To introduce the longitudinal capsulotomy technique with preservation of the iliofemoral ligament and to report its preliminary clinical results.Methods:The cases that underwent hip arthroscopic surgery in the Department of Sports Medicine of the Second Hospital of Shandong University between October 2018 and October 2019 were reviewed.All the included cases adopted the longitudinal capsulotomy technique and were followed up for at least six months.The patients’informations were recorded,as well as the operation time of capsulotomy,traction time,total operation time,intraoperative fluoroscopy,whether the joint capsule was closed,and the incidence of postoperative complications.The preoperative and postoperative hip function scores were compared.Statistical analysis was performed with independent t test.Results:A total of 62 cases were enrolled,among which the labral injury caused by hip impingement and borderline dysplasia of the hip were 53 cases.It took an average of(12±4)min to complete the capsulotomy with the longitudinal technique,and the average traction time during the procedure was(39±9)min;the total operation time was(127±15)min.Fluoroscopic positioning assistance was not required in 30.6%of the cases(19 cases),and closure of the joint capsule was performed in 72%of the cases(45 cases).There was no serious surgical complications,no reoperation,nor revision.The hip function score improved from(45±10)points before surgery to(77±9)points six months after the surgery(t=17.889,P<0.001).Conclusion:The use of a longitudinal incision technique outside the hip capsule,together with the closed management of the joint capsule,can better maintain the integrity of the joint capsule with good surgical safety and positive clinical outcome.

关 键 词：关节镜 关节囊 

分 类 号：R687.4[医药卫生—骨科学]