Arthroskopie des Hüftgelenks

Zusammenfassung

In den vergangenen Jahren hat sich die Arthroskopie des Hüftgelenks als weichteilschonendes minimalinvasives Verfahren zu einem etablierten Standard entwickelt. Durch die rasante Weiterentwicklung der Operationstechnik und die zunehmende Erfahrung in den anwendenden Zentren konnten die Indikationsstellung und die Behandlungsergebnisse wesentlich verbessert werden. Zudem liegen mittelfristige Ergebnisse (zwei bis fünf Jahre Nachuntersuchungszeitraum) der verschiedenen arthroskopischen Behandlungsoptionen vor. Eine Erweiterung der Technik stellt der Übergang vom arthroskopischen zum endoskopischen Einsatz am Hüftgelenk dar. Dies ermöglicht zum Beispiel die minimalinvasive Entfernung periartikulärer Ossifikationen und perilabraler Ganglien. In Einzelfällen wird die Hüftarthroskopie auch bei persistierenden Beschwerden nach Hüftprothesenimplantation eingesetzt. Nach einer kurzen Empfehlung sinnvoller präoperativer Untersuchungen und einer Einführung in die Operationstechnik werden die aktuellen Behandlungsmöglichkeiten und Ergebnisse des Verfahrens indikationsabhängig dargestellt.

Summary

In the last decade, hip arthroscopy could be established as a standard treatment in multiple different hip pathologies. As the procedure itself was improved for the patient benefit, several centers were specialized in hip arthroscopy and gained an excellent level of experience concerning this treatment. The indications were clearly defined and the clinical outcome was improved. In 2015 different studies could present mid-term clinical results for the evidence of hip arthroscopy. Further endoscopic extra articular hip preserving procedures were described, as the removal of heterotopic ossifications and the decompression of periacetabular cysts. Some arthroscopic indications even exist in the treatment algorithm following total joint replacement. In this article, the necessary preoperative diagnostic tools are presented, the method of hip arthroscopy is introduced and the indications are presented, related to their clinical outcome.

Schlüsselwörter

Arthroskopie - Hüftgelenk - femoroazetabuläres Impingement

Keywords

Arthroscopy - hip - femoroacetabular impingement

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