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Arthroskopische Eingriffe nach Oberflächenersatz des Hüftgelenks

Arthoscopic interventions after resurfacing of the hip joint

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Die Hüftarthroskopie hat sich zu einem sicheren und effektiven Verfahren entwickelt. Ihr Anwendungsspektrum umfasst jetzt auch die Abklärung von Schmerzen unklarer Ursache nach einer Arthroplastik. Diese Studie beschreibt die Technik der Arthroskopie nach Oberflächenersatz des Hüftgelenks und ihren Nutzen bei der Diagnose unklarer Schmerzen. Die Hüftarthroskopie kann einen Beitrag zur Diagnose von okkulten Infektionen, Metallionenallergien, Impingementläsionen, Iliopsoastendinopathien, Kapselverdickungen und unspezifischen Synovitiden leisten. Die dynamische Arthroskopie hilft v. a. bei der Erkennung von Makrobewegungen bei beginnender aseptischer Lockerung und femoroazetabulärem Impingement nach Arthroplastik. Die Arthroskopie kann auch therapeutisch zum Débridement und zur Spülung infizierter Endoprothesen, zur Exzision von Impingementläsionen, zur Durchtrennung der Iliopsoassehne, zum Kapselrelease, zur Entfernung freier Gelenkkörper und zur Synovektomie eingesetzt werden. Die Arthroskopie nach Hüftgelenkoberflächenersatz ist ein technisch manchmal anspruchsvolles, aber sicheres und nützliches Mittel in den Händen eines gut ausgebildeten Hüftchirurgen.

Abstract

Hip arthroscopy has evolved into a safe and effective procedure. The role of arthroscopy has widened and it has now entered the realms of resolving the mystery of the pain of unknown origin following arthroplasty. The technique of arthroscopy following resurfacing hip arthroplasty and its usefulness in diagnosing unexplained pain is described in this study. Hip arthroscopy can help diagnose occult infections, metal ion allergy, impingement lesions, iliopsoas tendinopathy, capsular thickening and non-specific synovitis. Dynamic assessment with arthroscopy especially aids in detecting macro-movement in early cases of aseptic loosening and post-arthroplasty femoroacetabular impingement. Hip arthroscopy also plays a therapeutic role in debridement and rinsing of infected arthroplasties, excision of impingement lesions, severance of the iliopsoas ligament, capsular release, removal of loose bodies and synovectomies. The arthroscopic procedure in resurfacing hip arthroplasty can be technically demanding but it is a safe and useful tool in the armamentarium of a properly trained hip surgeon.

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  1. The Richard Villar Practice, Wellington Hospital, 8a Wellington Place, NW8 9LE, London, UK

    A.S. Bajwa MRCSEd, MSc Orth, MPhil, Dip SEM, MFSEM, FRCS Tr & Orth & R.N. Villar

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  1. A.S. Bajwa MRCSEd, MSc Orth, MPhil, Dip SEM, MFSEM, FRCS Tr & Orth
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  2. R.N. Villar
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Correspondence to A.S. Bajwa MRCSEd, MSc Orth, MPhil, Dip SEM, MFSEM, FRCS Tr & Orth.

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Bajwa, A., Villar, R. Arthroskopische Eingriffe nach Oberflächenersatz des Hüftgelenks. Arthroskopie 22, 322–329 (2009). https://doi.org/10.1007/s00142-009-0533-z

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