[Progress in diagnosis and hip arthroscopic treatment of borderline developmental dysplasia of hip with Cam-type femoroacetabular impingement].

股骨髋臼撞击 医学 髋臼 髋关节镜检查 发育不良 骨盆 股骨 关节镜检查 口腔正畸科 外科 内科学
作者
Yinhao He,Xiaosheng Li,Hongwen Chen,Qiang Peng,Tiezhu Chen
出处
期刊:PubMed 卷期号:37 (5): 629-634
标识
DOI:10.7507/1002-1892.202301058
摘要

To summarize the biomechanical characteristics, diagnosis, and hip arthroscopic treatment of borderline developmental dysplasia of hip (BDDH) with Cam-type femoroacetabular impingement (Cam FAI).The literature on BDDH with Cam FAI at home and abroad in recent years was extensively reviewed and analyzed.In patients with BDDH and Cam FAI, the femoral neck anteversion angle and femoral neck shaft angle increase, the pelvis tilts, and the acetabulum rotates, resulting in instability of the hip joint. In order to maintain the stability of the hip joint, the direction of biomechanical action of the hip joint has changed, which further affects the anatomical structures such as the proximal femur and acetabular morphology. BDDH with Cam FAI can be diagnosed clinically by combining lateral center edge angle, anterior center edge angle, and acetabular index. BDDH with Cam FAI can be effectively treated through arthroscopic polishing of the edges of the acetabular proliferative bone, excision of Cam malformations, and minimally invasive repair of the glenoid lip and cartilage of the hip joint.Currently, there is no unified standard for the diagnosis and treatment of BDDH with Cam FAI. Minimally invasive treatment of the hip under arthroscopy can achieve good early- and medium-term effectiveness, and has certain advantages in repairing and maintaining the integrity of the glenoid lip and suturing/compression joint capsule. However, the long-term effectiveness needs to be further followed up to determine. The timing of surgery, intraoperative bone edge depth polishing, and joint capsule suturing/compression techniques also need to be further explored.总结临界型发育性髋关节发育不良(borderline developmental dysplasia of hip,BDDH)合并凸轮型股骨髋臼撞击综合征(Cam-type femoroacetabular impingement,Cam FAI)的生物力学特点、诊断及髋关节镜治疗研究进展。.广泛查阅近年来国内外BDDH合并Cam FAI相关研究文献并进行总结分析。.BDDH合并Cam FAI患者股骨颈前倾角及颈干角增大,骨盆倾斜及髋臼旋转,导致髋关节不稳定。为了维持髋关节稳定性,患者髋关节局部生物力学作用方向发生改变,进而影响了股骨近端、髋臼形态等解剖结构。临床可联合外侧中心边缘角及前中心边缘角、髋臼指数诊断BDDH合并Cam FAI。通过髋关节镜下对髋臼增生骨边缘进行打磨、切除Cam畸形,对髋关节盂唇及软骨进行微创修复,可有效治疗BDDH合并Cam FAI。.目前有关BDDH合并Cam FAI的诊治尚无统一标准。髋关节镜下微创治疗可获得较好早中期疗效,在修复并维持盂唇完整性及缝合紧缩关节囊方面具有一定优势,但远期疗效有待进一步随访明确,手术时机、术中打磨骨边缘深度、关节囊缝合/紧缩技术等也需进一步探讨。.

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