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Hip preservation
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DOI：10.1302/2058-5241.5.190074.png)
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Abstract
En 中文
Classical indications for hip preserving surgery are: femoro-acetabular impingement (FAI) (intraand extraarticular), hip dysplasia, slipped capital femoral epiphysis, residual deformities after Perthes disease, avascular necrosis of the femoral head. Pre-operative evaluation of the pathomorphology is crucial for surgical planning including radiographs as the basic modality and magnetic resonance imaging (MRI) and/or computed tomography (CT) to evaluate further intra-articular lesions and osseous deformities. Two main mechanisms of intra-articular impingement have been described: (1) Inclusion type FAI ('cam type'). (2) Impaction type FAI ('pincer type'). Either arthroscopic or open treatment can be performed depending on the severity of deformity. Slipped capital femoral epiphysis often results in a camlike deformity of the hip. In acute cases a subcapital re alignment (modified Dunn procedure) of the femoral epiphysis is an effective therapy. Perthes disease can lead to complex femoro-acetabular deformity which predisposes to impingement with/without joint incongruency and requires a comprehensive diagnostic workup for surgical planning. Developmental dysplasia of the hip results in a static overload of the acetabular rim and early osteoarthritis. Surgical correction by means of periacetabular osteotomy offers good long-term results.
Keywords:
femoro-acetabular impingement
hip arthros-copy
hip dysplasia
periacetabular osteotomy
surgical hip dislocation
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