{"title":"在股骨和上髁神经牵引加神经切除术下注射玻尿酸治疗髋关节疾病","authors":"","doi":"10.1016/j.eats.2024.102998","DOIUrl":null,"url":null,"abstract":"<div><p>The hip is the location for many disorders, such as osteoarthritis, femoroacetabular impingement syndrome, avascular necrosis of the hip, and cartilage injuries, all of which cause chronic pain, disability, and limitation. It is estimated that 10% of the population ≥40 years of age will present with hip pain. The line of treatment goes from nonsteroidal anti-inflammatory drugs, physical therapy, lifestyle modification, intra-articular injections, and hip surgery. This will depend on the pathology, age, lifestyle, and sport activity of each patient. Currently, hip joint intra-articular injections represent a viable option for those patients who are not candidates for surgery or simply those who do not want surgery. Among the controversial indications for a hip injection is moderate-to-severe arthritis (grades III and IV). Hip injections are considered a diagnostic and therapeutic procedure, with a sensitivity of 87% and specificity of 100% reported, and will differentiate between an intra-articular pathology versus an extra-articular pathology and a neuropathic pain arising from the lumbar spine. Radiofrequency nerve ablation or neurectomy of the femoral and obturator nerve has been implemented more frequently not only for patients with mild-to-moderate osteoarthritis but also in those who present with femoroacetabular impingement syndrome and cartilage lesions who do not wish to undergo surgery.</p></div>","PeriodicalId":47827,"journal":{"name":"Arthroscopy Techniques","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212628724001002/pdfft?md5=6611184638ecfe41d650b5fd81022eb4&pid=1-s2.0-S2212628724001002-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Injection of the Hip With Hyaluronic Acid Under Distraction Plus Neurectomy of the Femoral and Obturator Nerve\",\"authors\":\"\",\"doi\":\"10.1016/j.eats.2024.102998\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>The hip is the location for many disorders, such as osteoarthritis, femoroacetabular impingement syndrome, avascular necrosis of the hip, and cartilage injuries, all of which cause chronic pain, disability, and limitation. It is estimated that 10% of the population ≥40 years of age will present with hip pain. The line of treatment goes from nonsteroidal anti-inflammatory drugs, physical therapy, lifestyle modification, intra-articular injections, and hip surgery. This will depend on the pathology, age, lifestyle, and sport activity of each patient. Currently, hip joint intra-articular injections represent a viable option for those patients who are not candidates for surgery or simply those who do not want surgery. Among the controversial indications for a hip injection is moderate-to-severe arthritis (grades III and IV). Hip injections are considered a diagnostic and therapeutic procedure, with a sensitivity of 87% and specificity of 100% reported, and will differentiate between an intra-articular pathology versus an extra-articular pathology and a neuropathic pain arising from the lumbar spine. Radiofrequency nerve ablation or neurectomy of the femoral and obturator nerve has been implemented more frequently not only for patients with mild-to-moderate osteoarthritis but also in those who present with femoroacetabular impingement syndrome and cartilage lesions who do not wish to undergo surgery.</p></div>\",\"PeriodicalId\":47827,\"journal\":{\"name\":\"Arthroscopy Techniques\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2212628724001002/pdfft?md5=6611184638ecfe41d650b5fd81022eb4&pid=1-s2.0-S2212628724001002-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy Techniques\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212628724001002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Techniques","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212628724001002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
髋关节是许多疾病的发病部位,如骨性关节炎、股骨髋臼撞击综合征、髋关节血管性坏死和软骨损伤,所有这些疾病都会导致慢性疼痛、残疾和限制。据估计,年龄≥40 岁的人群中有 10% 会出现髋关节疼痛。治疗方法包括非甾体抗炎药、物理治疗、生活方式调整、关节内注射和髋关节手术。这取决于每位患者的病理、年龄、生活方式和运动量。目前,对于那些不适合手术或不想手术的患者来说,髋关节关节内注射是一种可行的选择。有争议的髋关节注射适应症包括中重度关节炎(III 级和 IV 级)。髋关节注射被认为是一种诊断和治疗程序,据报道其敏感性为 87%,特异性为 100%,可区分关节内病变与关节外病变以及腰椎引起的神经性疼痛。射频神经消融术或股骨和闭孔肌神经切除术已越来越多地应用于轻度至中度骨关节炎患者,也适用于不愿接受手术的股骨髋臼撞击综合征和软骨损伤患者。
Injection of the Hip With Hyaluronic Acid Under Distraction Plus Neurectomy of the Femoral and Obturator Nerve
The hip is the location for many disorders, such as osteoarthritis, femoroacetabular impingement syndrome, avascular necrosis of the hip, and cartilage injuries, all of which cause chronic pain, disability, and limitation. It is estimated that 10% of the population ≥40 years of age will present with hip pain. The line of treatment goes from nonsteroidal anti-inflammatory drugs, physical therapy, lifestyle modification, intra-articular injections, and hip surgery. This will depend on the pathology, age, lifestyle, and sport activity of each patient. Currently, hip joint intra-articular injections represent a viable option for those patients who are not candidates for surgery or simply those who do not want surgery. Among the controversial indications for a hip injection is moderate-to-severe arthritis (grades III and IV). Hip injections are considered a diagnostic and therapeutic procedure, with a sensitivity of 87% and specificity of 100% reported, and will differentiate between an intra-articular pathology versus an extra-articular pathology and a neuropathic pain arising from the lumbar spine. Radiofrequency nerve ablation or neurectomy of the femoral and obturator nerve has been implemented more frequently not only for patients with mild-to-moderate osteoarthritis but also in those who present with femoroacetabular impingement syndrome and cartilage lesions who do not wish to undergo surgery.