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中华关节外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (04) : 469 -474. doi: 10.3877/cma.j.issn.1674-134X.2020.04.013

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综述

关节镜下射频消融术治疗臀肌挛缩症的研究进展
单宇宙1, 颜连启2,(), 卢志华3, 朱磊1   
  1. 1. 225001 扬州大学临床医学院
    2. 225001 扬州大学临床医学院;225001 扬州,苏北人民医院骨科研究所
    3. 225001 扬州,苏北人民医院骨科研究所
  • 收稿日期:2019-10-30 出版日期:2020-08-01
  • 通信作者: 颜连启

Advances in arthroscopic radiofrequency ablation for gluteal muscle contracture

Yuzhou Shan1, Lianqi Yan2,(), Zhihua Lu3, Lei Zhu1   

  1. 1. Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou 225001, China
    2. Department of Orthopedics, Clinical Medical College of Yangzhou University, Yangzhou 225001, China; Institute of Orthopedics, Northern Jiangsu People’s Hospital, Yangzhou 225001, China
    3. Institute of Orthopedics, Northern Jiangsu People’s Hospital, Yangzhou 225001, China
  • Received:2019-10-30 Published:2020-08-01
  • Corresponding author: Lianqi Yan
  • About author:
    Corresponding author: Yan Lianqi, Email:
引用本文:

单宇宙, 颜连启, 卢志华, 朱磊. 关节镜下射频消融术治疗臀肌挛缩症的研究进展[J]. 中华关节外科杂志(电子版), 2020, 14(04): 469-474.

Yuzhou Shan, Lianqi Yan, Zhihua Lu, Lei Zhu. Advances in arthroscopic radiofrequency ablation for gluteal muscle contracture[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(04): 469-474.

关节镜下射频消融术是治疗臀肌挛缩症的有效微创手术方式。传统开放手术创伤大、具有较高的并发症风险,微创手术则创伤小、切口小、术后并发症少。该术式根据挛缩组织的位置在股骨大转子顶点周围作两小切口,经切口使用刮匙将皮下筋膜与挛缩组织钝性分离,形成一个大小足够的人工腔室,以置入整个关节镜器械;使用射频消融技术将臀肌挛缩带松解离断。该术式适用于Ⅰ级、Ⅱ级患者,而对于Ⅲ级患者或X线检查发现已有骨盆倾斜、骨盆变窄、变长,股骨颈干角增大等骨性改变的患者则慎用。关节镜下射频消融术治疗GMC临床疗效肯定,具有术中出血少、住院时间短、下床活动早、术后康复快及满意度高等优点。但该术式所伴随的并发症仍不可忽视,如血肿、坐骨神经损伤、外展肌肉无力、伤口感染及术后复发等。本文着重对关节镜下射频消融术治疗GMC的适应证选择、手术方法、临床疗效、并发症等几个方面作综述。

Arthroscopic radiofrequency ablation is an effective minimally invasive procedure for the treatment of gluteal muscle contracture. Traditional open surgery is traumatic and has a high risk of complications. Minimally invasive surgery has minor trauma, small incision and less postoperative complications. According to the position of the contracture tissue, the operation makes two small incisions around the apex of the greater trochanter of the femur. An enough artificial working space to be placed the entire arthroscopic instrument is created in the interval between the subcutaneous fascia and the contracture bands using curette through the incision. The contracture zone is disconnected with radiofrequency ablation technique. It is applicable to degree I and II patients, and may be used cautiously in degree III patients or patients with pelvic tilt, pelvic narrowing, lengthening, and increased femoral neck dry angle in X-ray examination. Arthroscopic radiofrequency ablation for the treatment of GMC has the advantages of positive clinical efficacy, less intraoperative blood loss, shorter hospitalization time, early getting out of bed, quicker postoperative rehabilitation and higher satisfaction. However, the complications cannot be ignored, such as hematoma, sciatic nerve injury, abductor muscle weakness, wound infection and postoperative recurrence. This article mainly reviewed the indications, surgical methods, clinical efficacy and complications of arthroscopic radiofrequency ablation for the treatment of GMC.

图1 骨盆侧倾角。两侧髂前上棘连线与水平线的夹角即为骨盆侧倾角
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