METHOD FOR DISSECTION OF THE HIP JOINT CAPSULE DURING ARTHROSCOPIC OPERATIONS IN PATIENTS WITH FEMOROACETABULAR IMPINGEMENT Russian patent published in 2023 - IPC A61B17/00 A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used for dissection of the hip joint capsule during arthroscopic operations in patients with femoroacetabular impingement. The method includes making an access, which is carried out using the proximal middle anterior arthroscopic port (PMAAP) and the middle anterior arthroscopic port (MAAP), to the capsule of the hip joint and subsequent capsulotomy with dissection of the iliac-femoral ligament. A skin incision is made for PMAAP, the beginning of which is located at the border of the proximal and middle third of the line connecting the anterior superior iliac spine and the apex of the greater trochanter, and continue it vertically down by 1.5 cm. Departing from the place of PMAAP and 7 cm distally, parallel to the first skin incision, a second incision is made for MAAP 1.5 cm long. L-shaped access to the joint is carried out through the ports, which starts from a point located 3 cm distal to the point of attachment of the curved straight head thigh muscles to the upper edge of the acetabulum towards the top of the greater trochanter and along the longitudinal fibers of the iliac-femoral ligament and continue it towards the place of attachment of the curved head of the rectus femoris muscle to the level of visualization of the edge of the acetabular lip. From MAAP, a ligature is passed through the thickness of the joint capsule in the region of the apex of the formed flap, a distal anterolateral port (DAP) is formed, located at the intersection of a line running parallel to the axis of the thigh at a distance of 2 cm from the anterior edge of the greater trochanter, and a line drawn perpendicularly through the middle of the iliac inguinal ligament. In the DAP, the ligature is removed and pulled so that a space is formed between the joint capsule and the femoral head. Then, the dissection of the hip joint capsule is continued in the transverse direction with respect to the fibers of the iliac-femoral ligament and along the edge of the acetabular lip to the level of the lower anterior iliac spine, keeping the ligature in tension towards the base of the femoral neck and thereby retracting the triangular flap of the hip joint capsule into the same direction. After carrying out the planned manipulations on the structures of the hip joint, the conducted ligature is oriented to the angle between the longitudinal and transverse parts of the L-shaped access and the head of the femur is closed with a selected triangular flap from its capsule, first suturing the transverse and then the longitudinal part of the L-shaped access.

EFFECT: method provides improved visualization and reduced damage to the iliofemoral ligament due to low invasiveness.

1 cl, 42 dwg, 2 ex