Nội soi Chỉ là một thay thế để thay khớp háng, không một thủ tục để Hãy coi cho triệu chứng nhẹ hơn liên quan đến căn bệnh này. Điều này quan trọng cho hai lý do. Đầu tiên, nếu năm đầy đủ KHÔNG đạt được đáp ứng, bệnh nhân phải Hãy chuẩn bị cho dù người đó sau đó IS đã sẵn sàng để xem xét thay thế hông. | CHAPTER 2 INDICATIONS AND CONTRAINDICATIONS 17 FIGURE . A 61-year-old man with a 6-month history of progressively worsening right hip pain. A AP radiograph reveals evidence of degenerative changes with underlying dysplasia but partial joint space preservation. B Arthroscopy reveals a hypertrophic degenerate ligamentum teres . C The deteriorated fibers are debrided. ing total hip arthroplasty. Arthroscopy is only an alternative to hip replacement not a procedure to be considered for milder symptoms associated with the disease. This is important for two reasons. First if an adequate response is not achieved the patient must be prepared for whether he or she is subsequently ready to consider hip replacement. Second some patients are able to live in a delicate equilibrium with the underlying degenerative changes for years. There is always the risk that attempted arthroscopic debridement may aggravate the process and inadvertently accelerate the need for arthroplasty. A moderately successful result of arthroscopic debridement can only be gauged as some improvement for some length of time. The subjective gauge is whether improvement is adequate enough to be satisfactory to the patient and of sufficient duration to have been deemed worthwhile. Jackson reports that arthroscopic debridement for degenerative disease of the knee results in approximately an 80 likelihood of some With proper patient selection it is hoped that this percentage could be approached for the hip. Thus far published results of arthroscopy for arthritis of the hip remain inferior to those of the knee. Sampson personal communication attributes this inability to achieve comparable results between the knee and hip to the differences in the joint architecture. The knee is a tricompartmental joint whereas the hip is a unicompartmental joint. Patients can selectively unload the medial or lateral 18 . THOMAS BYRD compartments of the knee simply by altering the way they walk and can avoid
