Abstract:
In patients with total hip arthroplasty (THA) with recurrent pain, symptoms may be caused by several conditions involving not just the joint, but also the surrounding soft tissues including tendons, muscles, bursae, and peripheral nerves. US and US-guided interventional procedures are important tools in the diagnostic work-up of patients with painful THA given that it is possible to reach a prompt diagnosis both directly identifying the pathological changes of periprosthetic structures and indirectly evaluating the response and pain relief to local injection of anesthetics under US monitoring. Then, US guidance can be used for the aspiration of fluid from the joint or periarticular collections, or alternatively to follow the biopsy needle to collect samples for culture analysis in the suspicion of prosthetic joint infection. Furthermore, US-guided percutaneous interventions may be used to treat several conditions with well-established minimally invasive procedures that involve injections of corticosteroid, local anesthetics, and platelet-rich plasma or other autologous products. In this review, we will discuss the clinical and technical applications of US-guided percutaneous interventional procedures in painful THA that can be used in routine daily practice for diagnostic and therapeutic purposes.
摘要:
在患有复发性疼痛的全髋关节置换术(THA)患者中,症状可能是由几种情况引起的,不仅涉及关节,还有周围的软组织,包括肌腱,肌肉,法氏囊,和周围神经。US和US指导的介入程序是诊断THA疼痛患者的重要工具,因为可以直接识别假体周围结构的病理变化并间接评估反应和疼痛缓解在US监测下局部注射麻醉药。然后,US引导可用于从关节或关节周围集合中抽吸液体,或者,在怀疑人工关节感染的情况下,跟随活检针收集样本进行培养分析。此外,美国指导的经皮介入治疗可用于治疗多种疾病,包括注射皮质类固醇的完善的微创手术。局部麻醉药,和富含血小板的血浆或其他自体产品。在这次审查中,我们将讨论US引导经皮介入手术在疼痛性THA中的临床和技术应用,这些手术可用于常规的日常诊断和治疗.