臀部关节镜检查
你需要知道的
- 髋关节镜检查期间, a surgeon uses a special device with a small camera to see inside the hip joint to determine the source of your symptoms.
- Hip arthroscopy can be used to clean out loose or damaged tissues from the joint, 修复撕裂，重塑骨骼.
- 你通常可以在髋关节镜检查后的当天回家.
- Recovery after a hip arthroscopy can take up to several months depending on which parts of the hip joint were operated on and your recovery goals.
什么是髋关节镜检查?
Hip arthroscopy is a minimally invasive same-day (outpatient) surgical procedure that uses a device called an arthroscope to diagnose and treat hip conditions. An arthroscope is a flexible tube with a camera that is connected to a video monitor. An orthopaedic surgeon makes a small incision (cut) close to the hip to insert the arthroscope and direct it toward the joint. 监视器显示髋关节组织的放大视图, 让外科医生看到伤口, 髋关节损伤或其他异常. Hip arthroscopy can be used to explore the cause of hip pain as well as to treat certain hip conditions at the same time. For treatment, the surgeon makes one or two additional cuts to insert special surgical tools.
髋关节镜检查| Q&A与亚历克斯·约翰逊, M.D.
谁是髋关节镜检查的候选人?
Hip arthroscopy is generally recommended for younger patients with hip pain who do not require a hip replacement. 他们疼痛的原因通常与髋关节的运动损伤有关, overuse injuries or abnormalities in the shape of the bones that make up the hip joint. Your doctor might recommend arthroscopy to repair soft tissue damage in the hip or to correct the shape and the fit of the hip bones. 髋关节镜检查通常不适合患有 骨关节炎.
Hip arthroscopy may be an option if you’ve been diagnosed with or if your doctor suspects:
- 臀部撞击:由于骨骼形状不规则，髋骨之间有挤压现象. 关节镜检查可以用来重塑骨骼.
- 髋唇撕裂髋窝周围软骨环的撕裂. 关节镜可用于清除受损的唇, 修复撕裂和解决潜在的原因，如髋关节撞击.
- 宽松的片段 of cartilage in the joint after an injury: Arthroscopy can help remove any debris from the hip joint.
- 骨刺 (osteophytes): bony bumps that form on the ends of the bones and can prevent the joint from gliding smoothly. Arthroscopy can be used to shave off the spurs and restore the shape of the joint.
- 滑膜炎:关节内层发炎. Arthroscopy can be used to remove the inflamed tissue as well as diagnose and treat the underlying causes.
Because these conditions may contribute to the development of hip arthritis over time, 用髋关节镜检查治疗可以帮助延缓或减缓关节炎, 从而推迟了髋关节置换术的需要.
约翰霍普金斯髋关节保存诊所
准备髋关节镜检查
Your doctor may recommend hip arthroscopy after reviewing your medical history, 进行身体检查及检查影像检查的结果(x射线、CT扫描或 核磁共振成像).
在你做手术的那天, an anesthesiologist will evaluate you to determine the best type of anesthesia. Hip arthroscopies can be performed under general anesthesia (you are asleep during the procedure) or regional anesthesia (you are awake, 但你的身体从腰部以下都麻木了).
Before your procedure begins, the surgeon will attach your leg to a special positioning device. The device features pulling and traction mechanisms to help the surgeon place your leg and hip at the proper angle for surgery. 然后外科医生会在你的皮肤上标出骨头的位置, 神经和血管被定位, 注意切口的位置.
在髋关节镜手术中会发生什么?
- The orthopaedic surgeon makes one or several small incisions to allow the arthroscope and other surgical tools to be inserted.
- 在插入关节镜之前, the surgeon guides a needle to the hip joint and injects the joint with fluid to create pressure that keeps the joint open and accessible for surgery.
- The surgeon uses the pathway created by the needle to insert a guide wire and then a tube, 关节镜通过它插入. 这种方法有助于减少对健康组织的损害.
- 当关节镜进入髋关节时, 显示器上显示关节和周围组织的图像, 让外科医生确定问题部位.
- The surgeon inserts different arthroscopic tools through other surgical openings to treat the problem.
- 一旦问题解决了, the surgeon closes the incisions using non-dissolvable sutures or surgical tape strips.
- The care team will monitor you in the recovery room as you come out of anesthesia.
- 只要你准备好出院, you will be given a pair of crutches to avoid putting too much pressure on the hip that was operated on. 你应该安排人开车送你回家.
髋关节镜检查恢复
Your surgeon may refer you to a physical therapist to help you gradually regain your mobility and strength after the hip arthroscopy. The physical therapist will offer instructions on specific hip stretches and exercises you can do at home. He or she will also provide guidance on when you can stop using crutches and start putting the full weight on your hip. 你可能需要继续练习六周或更长时间, 这取决于你手术前后的活动量.
你将与你的外科医生有一个后续的预约来拆除缝合线, 如果需要, as well as to discuss your pain levels and overall recovery goals and progress. 在手术后的一段时间内，你可能会感到髋关节疼痛, 但在三到六个月内，它应该会显著减少或消失. Your doctor will prescribe pain medications to help with pain during recovery. If your pain increases or feels like it’s sharp or stabbing, discuss it with your doctor.
You may also feel or hear fluid moving in your joint after the hip arthroscopy. 这是正常的，液体会被你的身体吸收. 任何涉及切口的外科手术, 你会在切口处留下小疤痕.
髋关节镜检查的风险和并发症
和大多数手术一样, 髋关节镜检查有损伤神经的风险, 手术部位周围的肌肉和血管, 也有被感染的风险. These risks are generally lower in minimally invasive procedures such as arthroscopy.
There is always a risk of the procedure not providing the desired symptom relief. 如果你在完全康复后仍然感到臀部疼痛, 与你的外科医生讨论接下来的步骤和其他治疗方案.
