Skip to main content
SpringerLink
Log in

Hüftarthroskopie – Indikationen und Grenzen

Hip arthroscopy – indications and limits

  • Leitthema
  • Published:
Der Orthopäde Aims and scope Submit manuscript

Zusammenfassung

Durch Verbesserung und stetige Weiterentwicklung der Technik hat sich die Hüftarthroskopie innerhalb der letzten 10 Jahre zu einem orthopädischen Standardverfahren entwickelt. Das Indikationsspektrum hat sich deutlich erweitert. Zu den Hauptindikationen zählen krankhafte Veränderungen der Synovialmembran, Schäden des Labrum acetabulare, Läsionen des Ligamentum capitis femoris, freie Gelenkkörper, degenerative und traumatische Knorpelläsionen sowie insbesondere Störungen der Gelenkmechanik verursacht durch das femoroazetabuläre Impingement. Zunehmend ermöglichen endoskopische Verfahren auch die Therapie periartikulärer Erkrankungen. Die schwierigen anatomischen Verhältnisse mit einer großen Distanz zum Gelenkkavum und die problematische Visualisierung des dorsomedialen Gelenkbereichs limitieren die Arthroskopie des Hüftgelenks. Dies gilt auch für die Tatsache, dass der Zeitraum für die Gelenkdistraktion und damit die im zentralen Hüftkompartiment zur Verfügung stehende Operationszeit bei Verwendung eines Traktionstisches begrenzt ist.

Abstract

Through continuous improvement and advancement of technology over the last 10 years, hip arthroscopy has developed into a standard orthopedic procedure and this has greatly expanded the range of indications. The main indications for hip arthroscopy include any disorder of the synovial membrane, damage to the labrum acetabulare, lesions of the ligament of the head of the femur, loose bodies, degenerative and traumatic cartilage lesions and especially disorders of the joint mechanism caused by femoroacetabular impingement. Increasingly, endoscopic procedures additionally allow the treatment of periarticular pathologies. Hip arthroscopy is limited in particular due to the difficult anatomy, a large distance from the skin to joint cavity and the problematic visualization of the posteromedial joint area. Furthermore, a time-limited distraction of the joint must be considered in the choice of therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Baker CL Jr, Massie RV, Hurt WG, Savory CG (2007) Arthroscopic bursectomy for recalcitrant trochanteric bursitis. Arthroscopy 23:827–832

    Article  PubMed  Google Scholar 

  2. Beck M, Kalhor M, Leunig M, Ganz R (2005) Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg [Br] 87:1012–1018

    Google Scholar 

  3. Botser IB, Smith TW Jr, Nasser R et al (2011) Open surgical dislocation versus arthroscopy for femoroacetabular impingement: a comparison of clinical outcomes. Arthroscopy 27:270–278

    Article  PubMed  Google Scholar 

  4. Boyer T, Dorfmann H (2008) Arthroscopy in primary synovial chondromatosis of the hip: description and outcome of treatment. J Bone Joint Surg [Br] 90:314–318

    Google Scholar 

  5. Brumback RJ, Ellison TS, Molligan H et al (1992) Pudendal nerve palsy complicating intramedullary nailing of the femur. J Bone Joint Surg [Am] 74:1450–1455

    Google Scholar 

  6. Burman MS (2001) Arthroscopy or the direct visualization of joints: an experimental cadaver study 1931. Clin Orthop Relat Res 390:5–9

    Article  PubMed  Google Scholar 

  7. Byrd JW, Jones KS (2000) Prospective analysis of hip arthroscopy with 2-year follow-up. Arthroscopy 16:578–587

    Article  PubMed  CAS  Google Scholar 

  8. Byrd JW, Jones KS (2004) Traumatic rupture of the ligamentum teres as a source of hip pain. Arthroscopy 20:385–391

    Article  PubMed  Google Scholar 

  9. Byrd JW (2005) Evaluation and management of the snapping ilipsoas tendon. Tech Orthop 20:45–51

    Article  Google Scholar 

  10. Byrd JW, Jones KS (2006) Adhesive capsulitis of the hip. Arthroscopy 22:89–94

    Article  PubMed  Google Scholar 

  11. Byrd JW, Jones KS (2009) Hip arthroscopy for labral pathology:prospective analysis with 10-year follow-up. Arthroscopy 25:365–368

    Article  PubMed  Google Scholar 

  12. Dienst M, Seil R, Gödde S et al (1999) Arthroscopy for diagnosis and therapy of early osteoarthritis of the hip. Orthopade 28:812–818

    Article  PubMed  CAS  Google Scholar 

  13. Dienst M, Grün U (2008) Complications of hip arthroscopies. Orthopade 37:1111–1115

    Google Scholar 

  14. Dorfmann H, Boyer T (1999) Arthroscopy of the hip: 12 years of experience. Arthroscopy 15:67–72

    PubMed  CAS  Google Scholar 

  15. Ellis HB, Briggs KK, Philippon MJ (2011) Innovation in hip arthroscopy: is hip arthritis preventable in the athlete. Br J Sports Med 45:253–258

    Article  PubMed  Google Scholar 

  16. Gautier E, Ganz K, Krügel N et al (2000) Anatomy of the medial femoral circumflex artery and its surgical implications. J Bone Joint Surg [Br] 82:679–683

    Google Scholar 

  17. Gonzalez Della Valle A, Piccaluga F, Potter HG et al (2001) Pigmented villonodular synovitis of the hip: 2–23-year followup study. Clin Orthop Relat Res 388:187–199

    Article  Google Scholar 

  18. Gross RH (1977) Arthroscopy in hip disorders in children. Orthop Rev 1977 VI:43–49

    Google Scholar 

  19. Ilizaliturri VM Jr, Martinez-Escalante FA, Chaidez PA et al (2006) Endoscopic iliotibial band release for external snapping hip syndrome. Arthroscopy 22:505–510

    Article  PubMed  Google Scholar 

  20. Kaminski A, Muhr G, Kutscha-Lissberg F (2007) Modified open arthroscopy in the treatment of septic arthritis of the hip. Ortop Traumatol Rehabil 9:599–603

    PubMed  Google Scholar 

  21. McCarthy J, Puri L, Barsoum W et al (2003) Articular cartilage changes in avascular necrosis: an arthroscopic evaluation. Clin Orthop Relat Res 406:64–70

    Article  PubMed  Google Scholar 

  22. McCarthy JC, Jibodh SR, Lee JA (2009) The role of arthroscopy in evaluation of painful hip arthroplasty. Clin Orthop Relat Res 467:174–180

    Article  PubMed  Google Scholar 

  23. Ochi T, Iwase R, Kimura T et al (1991) Effect of early synovectomy on the course of rheumatoid arthritis. J Rheumatol 18:1794–1798

    PubMed  CAS  Google Scholar 

  24. Philippon MJ, Schenker ML, Briggs KK et al (2008) Can microfracture produce repair tissue in acetabular chondral defects? Arthroscopy 24:46–50

    Article  PubMed  Google Scholar 

  25. Schoeniger R, Naudie DD, Siebenrock KA et al (2006) Modified complete synovectomy prevents recurrence in synovial chondromatosis of the hip. Clin Orthop Relat Res 451:195–200

    Article  PubMed  Google Scholar 

  26. Simpson JM, Field RE, Villar RN (2011) Arthroscopic reconstruction of the ligamentum teres. Arthroscopy 27:436–441

    Article  PubMed  Google Scholar 

  27. Stevens MS, Legay DA, Glazebrook MA et al (2010) The evidence for hip arthroscopy: rading the current indication. Arthroscopy 26:1370–1383

    Article  PubMed  Google Scholar 

  28. Villar RN (1992) Hip arthroscopy. Br J Hosp Med 47:763–766

    PubMed  CAS  Google Scholar 

  29. Voos JE, Rudzki JR, Shindle MK et al (2007) Arthroscopic anatomy and surgical techniques for peritrochanteric space disorders in the hip. Arthroscopy 23:1246e1–1246e5

    Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str. 1, Geb. 37, 66421, Homburg/Saar, Deutschland

    O. Steimer & U. Grün

  2. Orthopädie Am Alten Messplatz (OAAM), Mannheim, Deutschland

    M. Kusma

Authors
  1. O. Steimer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Kusma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U. Grün
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O. Steimer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Steimer, O., Kusma, M. & Grün, U. Hüftarthroskopie – Indikationen und Grenzen. Orthopäde 40, 1054–1060 (2011). https://doi.org/10.1007/s00132-011-1847-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00132-011-1847-x

Schlüsselwörter

Keywords

Search

Navigation