
hip arthroscopy

hip arthroscopy anedi keellanouka dwara acetabulofemoral (hip) keelu lopali bhaganni chudatam mariyu kaneesa invasive vidhanam dwara hip pathology chikitsanu suuchistumdi. eee saanketikata konnisaarlu vividha keella rugmatala chikitsalo sahaayapadataaniki upayoginchabadutundi mariyu saampradaaya shastrachikitsa paddhathulatho (konnisaarlu "open surgery" gaa suuchistaaru) polchinappudu upayoginche chinna kothalu mariyu takkuva recovery samayala kaaranamgaa prajaadarana pondindi. hip arthroscopy iteevala varaku saadhyam kaaledu, upayoginchina rendu sadhanalalo kotta saanketikata mariyu hip joint drushtini maralchagala saamarthyam hip arthroscopy chese saamardhyamlo iteevali perugudalaku mariyu daani prajaadaranaku daariteesindi.
charitra.
keella lopala chuudataaniki arthroscope vadakanni vivarinchina modati vyakti 1912loe denmark nundi severin nordentaft. appati nundi, arthroscopy rangam aneka keellaku roganirdhaarana mariyu chikitsa vidhaanaalanu kaligi undataaniki abhivruddhi chendindi. parikaraala tayari mariyu optical technologylalo saanketika purogatulu, kontavaraku, sarjanku perugutunna chinna ummadi pradaesaala yokka nammadagina veekshanhalanu pondadam sadhyapaddayi. ippudu, prapanchamlooni pramukha hip arthroscopy nipunulatoe kuudina hip arthroscopy (isha) kosam antarjaateeya sangham undhi.
arthroscopic paddhatulu hip paristhitulaku chikitsa cheyadaaniki marinta prachuryam pondina paddhatigaa marai. 1970laloe modatisaarigaa vivarinchinappatikii, sumaru 2000 nundi prapanchavyaaptamgaa nirvahinchina hip arthroscopic vidhaanaala suuchanalu mariyu sankhyalu vistrutamgaa vistarinchaayi. idhi pradhanamgaa phemorosetabular impimment (phai) mariyu acetabular labrum yokka kanneellu vanti rogalakshana paristhitula gurtimpu kaaranamgaa untundi.
faayi bhavananu modata smith-peterson varninchaaru. ayithe, phai yokka aadhunika roganirdhaarana mariyu chikitsaku 2003loe ganj maargadarsakatvam vahinchaaru, athanu praarambhamlo intra-articular pathology chikitsa kosam open surgical dislocation tekniknu upayoginchaalani vaadinchaaru. indulo hip jointku praapyata pondadaaniki 'trochanteric flip' vidhananni upayoginchadam jarigindi. idhi oka vistrutamaina vidhanam, keellaku praapyata pondadaaniki toda yokka pedda troconter mariyu daani jatacheyabadina kandaraala nirliptatatoe, nadumu vaipu tarachugaa pedda kotha avasaram. eee vidhananni upayoginchadam dwara, hip joint yokka bantini sackett nundi bayataku tippavacchu ('surgical dislocation' anie pilustaaru), idhi mottam jointku 360-degreela accessnu istundi. eee vidhanam, saadhaaranamgaa surakshitamainadigaa pariganhinchabadinappatiki, daanitoe paatu antarleena pramaadaalanu kaligi untundi, idhi anni pedda kotha shastrachikitsala vishayamlo untundi. sankramana mariyu raktam gaddakatte pramaadaalu ellappuduu untaayi, mariyu ganj mariyu athani sahacharulu heterotopic ossification (hip chuttoo kotta emuka nirmaanam), naraala gayalu, ekkuva troconter sarigga nayam cheyadamlo vaiphalyam, hip jointlo maccha kanajaalam (antukune) erpadina taruvaata nirantara noppi mariyu toda talaku rakta sarafara debbatine chinna pramaadam vanti samasyalanu udaharinchaaru. roogi saadhaaranamgaa konni rojulu aasupatrilo undaalsina avasaram undhi, mariyu atuvanti vistrutamaina shastrachikitsa tarvaata shastrachikitsa anantara punaravasam ekkuva kaalam undavacchu. phalitamgaa, pedda, bahiranga shastrachikitsa valla kalige aapadalanu nivaarinche prayatnamlo shastravaidyulu hip jointlo aarthroskopnu marinta vistrutamgaa upayoginchaalani chuusaaru. dheeni yokka grahinchina prayojanaalu pedda macchalanu nivaarinchadam, rakta nashtam taggadam, vaegamgaa kolukune vyavadhi mariyu takkuva noppi. hip aarthroskopeeni out patient prakriyagaa nirvahinchavacchu (i.ii. ratriputa aasupatrilo undaalsina avasaram ledhu).
suuchanalu.
hip aarthroskopeeni modatlo vivarinchaleni hip noppi nirdhaarana kosam upayoginchaaru, conny ippudu hip joint lopala mariyu velupala paristhitula chikitsalo vistrutamgaa upayogistunnaru. atyanta saadhaarana suuchana phai (toda acetabular impement) mariyu labral kanneellu mariyu mrudulaasthi asaadhaaranatalu vanti daani anubandha vyaadhula chikitsa kosam, itarulatoe paatu ("pattika 1 chudandi").
pattika 1. arthroscopicga chikitsa cheyagala hip paristhitula empika.
saanketikata.
roogi nidristunnappudu (saadhaarana mattumandu) ledhaa vennemuka anaesthesia kinda eee prakriya nirvahistaaru. rendu vistrutamgaa upayoginche paddhatulu unnaayi, okati roogi venuka bhaagamlo (nidraavasthaloo) mariyu marokati vaari vaipu (parshwa decubitus). idhi shastrachikitsakudi praadhaanyatapai aadharapadi untundi. hip joint yokka kendra compartmentku (banthi mariyu sackett madhya) praapyata pondadaaniki, paadaanni pratyeka bootlo unchina tarvaata prabhaavita kaaliki traction vartinchabadutundi. (anjeera chudandi. 2) dheeni kosam pratyaekamgaa roopondinchina parikaraalu unnaayi, ayithe kontamandi sarjanlu 'traction table' nuu upayogistaaru, idhi praarambhamlo virigina toda mariyu diguva kaalu emukala operative sthireekaranalo sahaayapadataaniki roopondinchabadindi. avasaramaina traction (ledhaa pull) mottaanni fluoroscopy (takkuva motaadu portable ex-rae) sahayamtho anchanaa vaestaaru. (anjeera chudandi. 3) konni millimetres kante ekkuva tractiontho sackett nundi bantini mallinchadam saadhaaranamgaa saadhyam kaadu. okasari shastravaidyudu vaaru hip jointku praapyata pondagalarani santoshinchina tarvaata (i.ii. banthi sackett nundi chinna mottamlo drushtini maralchutundi), appudu rogiki kriminaasakamtoe paint cheyabadutundi mariyu shastrachikitsa droplanu vartimpajestaaru.
tadupari dasha hip jaayintloki ex-rae maargadarsakatvamlo oka chakkati suudini choppinchadam. idhi keella 'chushana mudra' nuu vichchinnam chestundi mariyu avasaramaite marinta paradhyanam kaligistundi (chitram 4 chudandi). banthi sackett nundi sumaru 1 centimeters varaku bayataku vellaalani sarjan korukuntadu, tadwara keella uparitalaalaku nashtam kaliginche kaneesa pramaadamtoe hip jointku praapyatanu saadhinchavachchu. chaalaa mandhi shastravaidyulu eee dasalo keellaloki dravamnu inject chestaaru, surakshitamaina parikaraala access kosam banthi mariyu sackett madhya taginanta sthalam undani nirdhaarinchadaaniki. aaa taruvaata eee suudini tolagistaaru.
tadupari dasha 'portals' nuu unchadam, ledhaa keellaloki parikaraalanu pampadaaniki chesina chinna randhraalu. ex-rae niyantranalo, saadhaaranamgaa konchem bhinnamaina sthithilo, mallee oka taja bolu suudini keellaloki pampadam dwara idhi saadhinchabadutundi. dheeniki kaaranam emitante, suudi, mariyu tadupari kanyulalu acetabular labrum ledhaa mrudulaasthi keella uparitalaaloki chochukupoyi debbatinakunda sarjan nirdhaarinchagaladu (anjoorapu chudandi. 5). mallii, sarjanlu tamaku ishtamaina placement vishayamlo vaari swantha praadhaanyatalanu kaligi untaaru. eee bolu suudi dwara, podavaina sannani anuvaina guide wire keellaloki pravesistundi, mariyu suudi daani meeda nundi tolaginchabadutundi, guide wire sthaanamlo vadiliveyabadutundi. portal dwara vairpai pedda kanulanu unchadaaniki veelugaa wire chuttoo charmamlo oka chinna kotha cheyabadutundi. anduvalla wire pedda canyulaanu keellaloki nadipistundi. upayoginche kanula yokka atyanta saadhaarana bahya vyasalu 4.5 mariyu 5.5 mimi madhya untaayi. canuela saraina sthithilo undani sarjan santrupti chendina tarvaata, anubhooti mariyu ex-rae maargadarsakatvam kalayika dwara, guide vairnu upasamharinchukovachhu. modati portal sarigga unchina tarvaata, camera sthaanamlo unna tarvaata, ummadi uparitalaalapai kaneesa pramaadamtoe unchela chuudataaniki, marinni portallanu srushtinchavachu. shastrachikitsaku avasaramainanta hip jointku pravesinchadaaniki eee prakriyanu punaraavrutam cheyavachu, saadhaaranamgaa rendu mariyu naalugu madhya. eee pravesha binduvulalo konni veekshanha keellanouka kosam mariyu marikonni nirvahana parikaraala kosam upayoginchabadataayi.
operation appudu praarambhamavutundi, vividha rakaala parikaraalu upayoginchabadataayi. shastravaidyudu keellanouka dwara hip joint lopali bhaganni veekshistundagaa, itara operating parikaraalu itara portals dwara pravesapettabadataayi. shastrachikitsakudu banthi mariyu sackett madhya avasaramaina prakriyanu puurti chesina tarvaata, tarachugaa hip yokka 'central compartment' gaa suuchistaaru, traction vidudala cheyabadutundi, idhi hip yokka bantini daani saaketloki soukaryavantamgaa kuurchoevadaaniki veelu kalpistundi. arthroscope appudu 'paridheeya compartment' kuu taralinchabadutundi, idhi hip joint lopala inca banthi mariyu sackett bhaagam velupala unna praantam.
saadhaaranamgaa upayoginche arthroscopic sadhanalu hip yokka samagrata mariyu sthirathvaanni anchanaa vaeyadaaniki upayoginche hook probe, mruduvaina kanajaalaanni tagginche radiofrequency probes mariyu kanajaala uparitalaalanu sunnitamgaa cheyagalavu mariyu vyaadhigrasta kanajaalaanni tolaginchagala vividha shaverlu ledhaa burse. acetabular labramku marammattu avasaramaite, pratyaekamgaa roopondinchina langarulanu upayoginchavacchu. kotta parikaraalu nirantaram abhivruddhi cheyabadutunnanduna idhi yea vidhamgaanuu samagra jabita kaadu.
km-rakam phemorosetabular impimment.
toda thala-meda junction asadhaaranamgaa abhivruddhi chendadam dwara com impement erpadutundi, idhi gatamlo 'pistal-grip vaikalyam' gaa varninchabadindi. eee rakamaina vaikalyam anedi thala-meda koodali vadda puurva mariyu unnata toda medapai vividha mottaalalo asaadhaarana emukala dwara vargeekarinchabadutundi (anjoorapu chudandi. 6). thala-meda junction hip banthi diguvana untundi, akkada adhi chinna medalo kalustundi, idhi emuka ledhaa todaloki krindiki teesukuvelutundi. thala-meda junction vadda emuka poduchukune ledhaa bump anedi tirige parikaramlo asaadhaaranamaina bhaagamaina kaamtho polchabadindi. idhi pradhanamgaa vangadam mariyu/ledhaa antargata bhramanamtho golakaramlo laeni toda thala asitaabulamloki balavantamgaa pravesinchadam phalitamgaa keella nashtaniki daariteestundi. idhi keella mrudulaasthiki kudimpu mariyu kotha saktulanu andinchavacchu, mariyu labral kanneellaku daariteeyavachchu mariyu cartilege delimination anie pilavabade antarleena emuka nundi keella mrudulaasthi tokkadaaniki daariteeyavachchu (anjoorapu chudandi. 8).
rogalakshana com phai yokka praamaanika arthroscopic chikitsalo hip yokka kendra compartmentlo edainaa labral mariyu condral gayalanu debride cheyadam (vichhedanam) ledhaa marammattu cheyadam, mariyu paridheeya compartmentlo eguva toda toda (osteocondroplasty) yokka thala-meda junctionnu hye-speed motaru cheyabadina barlanu upayoginchi reshopping cheyadam untaayi, ivi dantavaidyudi drill roopakalpanalo pooli untaayi (anjoorapu chudandi. 9).
pinsar-rakam phemorosetabular impimment.
dheeniki viruddhamgaa, pincture impigment anedi hip joint yokka acetabular vaipu asaadhaaranata phalitamgaa untundi. acetabulum saadhaaranam kante ekkuva prushtha dhoranini kaligi undavacchu, lekapothe dheenini acetabular reterversion anie pilustaaru (epi radiographlapy crossover sainga chudabadutundi), ledhaa anchu chuttoo adanapu emuka undavacchu. dheeni phalitamgaa hip kadalika samayamlo acetabulum yokka labrum mariyu anchuku vyatiraekamgaa toda medanu taakadam jarugutundi. toda meda mariyu acetabulum anchu madhya padepade taakadam valla labrum mariyu prakkane unna keella mrudulaasthi debbatinavacchu. emuka nirmaanam ledhaa labrum lopala ossification saadhaaranamgaa eee punaraavruta parichayam phalitamgaa chudavachu. eee rakamaina impigment kooda austio arthuritis abhivruddhiki avakaasam kaligistundani bhaavistunnaaru.
pinsar impigment yokka arthroscopic chikitsa yokka lakshyam hip yokka coverage meeda acetabularnu tagginchadam. sackett dwara banthi yokka eee adhika kavarejeeni tagginche paddhatulalo labral detachment ledhaa peal byaak, burse upayoginchi acetabular rim trimming, tarachugaa prakriya mugimpulo labramnu yankarlatho tirigi jodinchadam vantivi unnaayi. hip yokka teevramaina global ovar coverage kesulu, ledhaa ippatike unna labrum emukagaa maarina (ledhaa ossified) paristhitulu minaha, hip joint contact pressureslo itrogenic perugudalanu nivaarinchadaaniki adhika acetabular rim vichhedanam nivaarinchaali.
laber kanneellu.
acetabular labrum anedi oka peechu nirmaanam, idhi toda thala chuttoo untundi. idhi hip jointku oka mudranu yerparustundi, ayithe daani nijamaina paniteeru sarigga ardham kaaledu. banthi mariyu sackett keella sthirathvaanni nirvahinchadaaniki mariyu acetabulanku toda toda yokka sparsha ottidini tagginchadaaniki eee hydraulic seal chaalaa mukhyamani iteevali aadharalu niroopinchaayi. labramku naraala sarafara kooda unnatlu choopabadindi mariyu debbatinte noppini kaliginchavacchu. labrum yokka diguva bhaagam acetabular articular mrudulaasthitho nirantaramgaa untundi, kabatti labramnu prabhaavitam chese edainaa sampeedana saktulu kooda articular mrudulaasthi debbatinavacchu, mukhyamgaa rendinti madhya koodali vadda, condrolabral junction. phai ledhaa dysplasia (nissara hip sackett) vanti antarleena prakriyaloo bhaagamgaa labrum debbatinavacchu ledhaa chirigipovacchu ledhaa baadhaakaramaina sanghatana valla neerugaa gaayapadavachu. kanneeti rakanni batti, labramnu kattirinchavacchu (debride cheyavachu) ledhaa marammatu cheyavachu. labrumnu tolaginchadam ledhaa debride cheyadam takkuva prachuryam pondutondi, endukante labrumnu marammatu cheyagaligithe deerghakaalamlo phalitaalu marinta oohinchadaginavani taja parisoedhanalu chuupistunnaayi. labral marammattu kosam vividha paddhatulu andubaatulo unnaayi, pradhanamgaa ankerlanu upayoginchi, ivi antarleena emukaku vyatiraekamgaa labramnu tirigi sthireekarinchadaaniki upayoginchavacchu, idhi sthithilo nayam cheyadaaniki veelu kalpistundi.
hip arthroscopy kotta paddhatulu prabalamgaa unnaayi. rogiki gatamlo labral debridement unte, ossified labrum unte ledhaa prastuta labrum marammattu kosam chaalaa chinnadi ledhaa gayapadinatlayite labral punarnirmaanam cheyadam dwara kotta labrum srushtiki maddatu ivvadaaniki manchi aadharalu unnaayi. labral punarnirmaanamlo roogi sonta kanajaalam (autograft) nundi ledhaa mrutadeha kanajaalam (allographt) nundi kotta labramnu srushtinchadam untundi. kotta labrum appudu emuka langarulatho sthaanamloki langaru veyabadutundi mariyu hip vistrutamaina punaravasam dwara velutundi.
adanapu keella syndromelu.
hip keella gulika velupala unna itara paristhitulaku chikitsa cheyadaaniki kooda hip aarthroskopnu upayoginchavacchu. veetilo grater trochanteric peyin syndrome (gtps), snapping illiotibial byaand, pyriphormis syndrome, deep glutial syndrome mariyu ischaeophamoral impigment unnaayi. veetilo ekkuva bhaagam kottagaa vivarinchina paddhatulu ayinappatikee, phalitaalu anukuulamgaa kanipistaayi.
samasyalu.
hip arthroscopy saadhaaranamgaa chaalaa surakshitamaina saanketikata. ayithe, anni shastrachikitsa vidhaanaala maadirigaane, pramaadaalu mariyu samasyalu undavacchu. veetini operation yokka saadhaarana samasyalu mariyu hip aarthroskopeeki pratyaekamainavigaa vibhajinchavachhu.
mattumandu samasyalu.
mattumandu samasyalu adrushtavasaattuu chaalaa arudu, conny shastrachikitsa tarvaata chaatii infection, moothra nilupudala (moothram paaraveyalekapovadam), jeernasayaantara samasyalu (malabaddhakam, vikaram), gunde samasyalu (asaadhaarana laya vantivi) mariyu maranam kooda unnaayi.
shastrachikitsa samasyalu.
asaadhaaranamainappatikii, 1 saatam kante takkuva, hip arthroscopy tarvaata sankramana pramaadam ellappuduu untundi. raktam gaddakattadam (lothaina-sira raktam gaddakattadam) kooda pramaadam, bahusha taggina kadalika phalitamgaa siralalo rakta pravaham mandaginchadam dwara srushtinchabadutundi.
konnisaarlu shastrachikitsa parikaraalatoe pratyaksha nashtam ledhaa keellaku praapyata pondadaaniki avasaramaina traction phalitamgaa, hip joint chuttoo unna naralaku nashtam jaragavacchu. eee kaaranamgaa, keellaku surakshitamaina praapyatanu pondadaaniki, shastrachikitsakulu veelainanta takkuva samayam kosam, veelainanta takkuva tractionu vartimpajeyadaaniki ishtapadataaru. toda yokka parshwa charma naraalu gayapadina atyanta saadhaarana naraalu. eee naram toda eguva, bayati bhaagaaniki anubhootini andistundi. prabhaavitamayye itara naraalu sandhivaatam (paadaanni paiki ettadam balaheenataku daariteestundi-'phut-drop'), toda toda (balaheenamaina toda kandaraalu), obturator (toda lopali bhaagamlo timmiri mariyu aaa kandaraala balaheenata), mariyu pudendal naraalu. pudendal naraalu punarutpatti avayavalaku anubhootini andistaayi.
hip arthroscopy tarvaata hip chuttoo unna mruduvaina kanajaala nirmaanaalaku nirantara vaapu asaadhaaranam kaadu. idhi saadhaaranamgaa sweeya-parimiti mariyu kalakramena merugupadutundi, ayithe appudappudu shotha nirodhaka chikitsa avasaram. atyanta saadhaaranamgaa prabhaavitamaina praantam hip velupali vaipu untundi (ekkuva troconter), ayithe iliopsos (hip mundu bhaagamlo neerugaa vellae kandaram) vaapu kooda sambhavinchavachhu.
anni arthroscopic vidhaanaala maadirigaane, hip arthroscopy keellalooni dravam thoo chepattabadutundi kabatti, shastrachikitsa samayamlo kondaru chuttupakkala kanajaalaaloki tappinchukuni sthaanika vaapuku kaaranamayye pramaadam undhi. konnisaarlu, idhi charmam pokkulaku kaaranamavutundi. ayithe, vaapu saadhaaranamgaa 24 gantala tarvaata jokyam lekunda parishkarinchabadutundi. chaalaa arudugaa eee neetipaarudala dravam kontha pottikadupuloki paiki cherutundi. idhi sambhavinchinatlayithe, shastrachikitsa tarvaata ventane roogi vennunoppi gurinchi firyadu cheyavachu.
shastrachikitsa anantara punaravasam.
prati shastravaidyudiki vaari swantha ishtapade physiotherapy schedule untundi. chaalaa mandhi vaari swantha websitelalo unnaaru. hip arthroscopy tarvaata ooyalapai maarutunna kaalam saadhaaranam, ayithe shastrachikitsa tarvaata kolukovadamlo physiotherapy chaalaa mukhyamaina paatra pooshistundani chaalaa mandhi chuustaaru. eee paalana saadhaaranamgaa tadupari dynamic, plymetric mariyu baruvula vyaayaamaalaku daariteese uchita kadalika, saagateeta mariyu isometric vyayamala prothsaahamtho praarambhamavutundi. prabhava karyakalapalu saadhaaranamgaa kaneesam moodu nelala paatu nirutsaahaparustaaru, mariyu naalugu nelala paatu kreedalanu sampradistaaru. shastrachikitsa tarvaata modati roeju saadhaarana stationary pedal parikaranni upayoginchadam shastrachikitsa tarvaata takshana vasyata mariyu chalanaseelataku keelakam.
phalitaalu.
hip arthroscopic paddhatula phalitaalu operationku sambandhinchina suuchanapai mariyu bahusha sarjan anubhavampai kooda aadharapadi untaayi. prachurinchina nivedikalu khachitamgaa prothsaahakaramgaa unnaayi, mariyu hip arthroscopic shastrachikitsa phalitaalanu nivedinche parisoedhanaa patraala sankhya vaegamgaa perugutondi. sumaruga, arthroscopicalga nirvahinchina phai shastrachikitsa kosam, 80 saatam mandhi rogulu operation tarvaata oka samvatsaram tarvaata tama pandlu merugupaddaayani bhaavistaaru, 15 saatam mandhi tama lakshanaalu maraledani bhaavistaaru, 5 saatam mandhi marinta digajaaravachu. prarambha arthuritis (ware und tear) kosam prakriya nirvahinchabadutunte, phalitaalu antha spashtamgaa undavu, mariyu pedda nishpatti prayojanam pondakapovacchu.
anatomy.
hip anedi tappanisarigaa banthi mariyu sackett ummadi. idhi toda (banthi) mariyu acetabulum (sackett) yokka talanu kaligi untundi. banthi mariyu sackett rendoo ekaswaramgaa untaayi mariyu hyline (ledhaa keelu) mrudulaasthitho kappabadi untaayi, idhi rendu uparitalaala madhya mruduvaina, daadaapu gharshana laeni glidingnu anumatistundi. acetabulum anchu chuttoo "acetabular labrum" untundi, idhi toda talanu chuttumutte peechu nirmaanam. (anjeera chudandi. 1) labrum toda thala chuttoo seal ledhaa gasketga panichestundi. ayithe, idhi daani ekaika pani kaadu, endukante idhi naraala chivaralanu kaligi unnatlu choopabadindi, idhi debbatinte noppiki kaaranam kaavacchu. labrum yokka rakta sarafara kooda pradarsinchabadindi. keelu kooda oka mandapati, peechu keella gulikatho chuttabadi untundi, idhi sainoviyamtho kappabadi untundi. hip jointnu unche snaayuvulu vaastavaaniki, ummadi gulika yokka mandamaina praantaalu, vibhina nirmaanaalu kakunda. sinovium keellanu saralikrutam chese dravamnu utpatti chestundi; aaa dravam mrudulaasthi kanaalanu sajeevamgaa unchadaaniki avasaramaina poeshakaalu. mottam 27 kandaraalu hip jointnu daatutaayi, idhi arthroscopic access kosam sareeramlo chaalaa lothaina bhaagamgaa maarutundi. hip arthroscopy saanketikamgaa chaalaa demand cheyadaaniki idhi oka kaaranam.
sackett yokka mrudulaasthi lining oka viloma gurrapu naala aakaaramlo untundi. dheeni madhyalo unna bhaganni cotiloid fosa antaaru. cotiloid fosa nundi udbhavinchi, toda talaku anusandhaaninche ligamentum terres untundi. peddavaarilo dheeni paniteeru charchaneeyaamsamgaa undhi, conny baalyamlo ligamentum terres pottikadupu nundi toda thala varaku raktanaalaanni teesukuvelutundi. eee raktanaalaalu saadhaaranamgaa vayassutho paatu anavasaramgaa marutayi. asthipanjara terres hip joint yokka antargata sthireekaranagaa panichestundani arthroscopic hip sarjanlu ekkuvagaa nammutunnaru, mariyu snaayuvuku pathological gaayam ippudu hip noppi mariyu asthirataku gurtinchabadina kaaranam.

