Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2019 Vol. 27 No 6

EXCHANGE OF EXPERIENCE

A.E. MURZICH

ARTHROSCOPY IN THE DIAGNOSIS AND TREATMENT OF HIP JOINT PATHOLOGY

Republican Scientific and Practical Center of Traumatology and Orthopedics, Minsk,
The Republic of Belarus

Objective. To estimate the possibilities and results of arthroscopy in different hip joint pathologies in young patients.
Methods. The results of 32 hip joint arthroscopy in cases of “cam” and “pincer” types of femoroacetabular impingement, chondromatosis and synovitis of the hip joint, osteoid osteoma of the acetabulum, osteonecrosis of the femoral head were analyzed. In 70% of cases, surgery was performed in adult patients aged 25 to 44 years. Hip arthroscopy was conducted in the patient’s supine position under general anesthesia through 3 ports: anterolateral, anterior, proximal anterolateral. 30° and 70° telescopes, 180 mm bone drills and aggressive cutters were used.
Results. A positive clinical effect due to the relief of pain and increase range of motion in the hip joint was obtained by arthroscopic treatment of femoroacetabular impingement. In one case the progression of coxarthrosis was observed, which required the total hip replacement in terms of 1.5 years after arthroscopy. In two cases the heterotopic soft tissue ossification in the projection of m. Iliopsoas was noted. Resection of the osteoid osteoma of the acetabulum under arthroscopic control is an effective less traumatic treatment for subchondral localization. Arthroscopic joint debridement in cases of coxarthrosis and osteonecrosis of the femoral head in some cases improves the clinical outcome of treatment by reducing the effusion in the joint and capsular tension. Intraosseous osteoscopy of the femoral head allowed visualizing the site of necrosis and monitoring the process of intraosseous osteoperforation.
Conclusions. The primary analysis of the results of hip arthroscopy showed its high efficiency as a minimally invasive method of diagnosis and treatment in a number of pathological conditions. The development of this direction of arthroscopy is possible only with the availability of specialized equipment and the improvement of surgical skills.

Keywords: hip arthroscopy, femoroacetabular impingement, osteonecrosis, femoral head, osteoid osteoma
p. 723-731 of the original issue
References
  1. Byrd JWT. Hip arthroscopy, the supine approach: technique and anatomy of the intraarticular and peripheral compartments. Tech Orthop. 2005 Mar;20(1):17-31. doi: 10.1097/01.bto.0000152172.34187.bf
  2. Joan C. Monllau, F. Reina-de la Torre, Lluis Puig, A. Rodrı'guez-Baeza. Arthroscopic Approaches to the Hip Joint. Tech Orthop. 2005 Mar;20(1):2-8. doi: 10.1097/01.bto.0000152170.52739.9a
  3. Burman M. Arthroscopy or the direct visualization of joints. JBJS. 1931 Oct;13(4):669-95.
  4. Konyves A. Editorial Commentary: International Society for Hip Arthroscopy Surgeons! Time for a Rethink on Rehabil Arthroscopy. 2017 Nov;33(11):2006. doi: 10.1016/j.arthro.2017.08.272
  5. Marin-Pena O, Tey-Pons M, Perez-Carro L, Said HG, Sierra P, Dantas P, Villar RN. The current situation in hip arthroscopy. EFORT Open Rev. 2017 Mar;2(3):58-65. doi: 10.1302/2058-5241.2.150041
  6. Milyukov AY. Arthroscopy of hip joint. Politravma. 2006;(2):22-25. https://cyberleninka.ru/article/n/artroskopiya-tazobedrennogo-sustava (In Russ.)
  7. Orletskii AN, Malakhova SV, Ogarev EV. Artroskopicheskaia khirurgiia tazobedrennogo sustava. Moscow, RF; 2004. 104 p. http://www.booksmed.com/ortopediya/2079-artroskopicheskaya-xirurgiya-tazobedrennogo-sustava-mironov-prakticheskoe-posobie.html (In Russ.)
  8. Sampson T.G. Arthroscopic treatment of femoroacetabular impingement. Techniques in Orthopaedics. 2005;20(1):56-62. http://hiparthroscopy.net/wp-content/uploads/2017/11/Techniques_in_Orthopaedics_2005_publication.pdf
  9. Jäger M, Wild A, Westhoff B, Krauspe R. Femoroacetabular impingement caused by a femoral osseous head-neck bump deformity: clinical, radiological, and experimental results. J Orthop Sci. 2004;9(3):256-63. doi: 10.1007/s00776-004-0770-y
  10. Byrd JWT. Evaluation and management of the snapping iliopsoas tendon. Techniques in Orthopaedics. 2005 Mar;20(1):45-51. doi: 10.1097/01.bto.0000152171.09968.1d
  11. Ilizaliturri VM, Reveles-Castillo R, Ramos-Aviña C, Camacho-Galindo J. Arthroscopy for hip dysplasia: indications and limitations. Tech Orthop. 2005 Mar;20(1):52-55. doi: 10.1097/01.bto.0000152165.81193.ee
  12. Khan M, Ranawat A, Williams D, Gandhi R, Choudur H, Parasu N, Simunovic N, Ayeni OR. Relationship between the alpha and beta angles in diagnosing CAM-type femoroacetabular impingement on frog-leg lateral radiographs. Knee Surg Sports Traumatol Arthrosc. 2015 Sep;23(9):2595-600. doi: 10.1007/s00167-014-3182-3
  13. Bouma H, Slot NJ, Toogood P, Pollard T, van Kampen P, Hogervorst T. Where is the neck? Alpha angle measurement revisited. Acta Orthop. 2014 Apr;85(2):147-51. doi: 10.3109/17453674.2014.899841
  14. Casartelli NC, Brunner R, Maffiuletti NA, Bizzini M, Leunig M, Pfirrmann CW, Sutter R. The FADIR test accuracy for screening cam and pincer morphology in youth ice hockey players. J Sci Med Sport. 2018 Feb;21(2):134-138. doi: 10.1016/j.jsams.2017.06.011
  15. Mochizuki Y, Kokubo Y, Yamazaki T. The prevalence of radiographic signs of pincer type morphology in a population based cohort study of asymptomatic Japanese. Hip Int. 2016 Jul 25;26(4):404-8. doi: 10.5301/hipint.5000358
  16. Gille J, Krueger S, Aberle J, Boehm S, Ince A, Loehr JF. Synovial chondromatosis of the hip: a case report and clinicopathologic study. Acta Orthop Belg. 2004 Apr;70(2):182-88. http://www.actaorthopaedica.be/acta/download/2004-2/17-gille%20et%20al.pdf
  17. Papavasiliou A, Yercan HS, Koukoulias N. The role of hip arthroscopy in the management of osteonecrosis. J Hip Preserv Surg. 2014 Oct 8;1(2):56-61. doi: 10.1093/jhps/hnu011
  18. Benyass Y, Chafry B, Koufagued K, Chagar B. Osteoid osteoma of the acetabular roof: a case report. J Med Case Rep. 2016;10(1):232. Published online 2016 Aug 24. doi: 10.1186/s13256-016-1016-2
Address for correspondence:
220024, The Republic of Belarus,
Minsk, Kizhevatov Str., 60/4,
Republican Scientific and Practical
Center of Traumatology and Orthopedics,
Laboratory of Joint Pathology
And Sports Injury.
Tel. +375 17 212 32 88,
e-mail: mae77@list.ru,
Alyaksandr E. Murzich
Information about the authors:
Murzich Alyaksandr E., PhD, Head of the Laboratory of Joint Pathology and Sports Injury, Republican Scientific and Practical Center of Traumatology and Orthopedics, Minsk, Republic of Belarus.
https://orcid.org/0000-0003-1625-7321
Contacts | ©Vitebsk State Medical University, 2007-2023