Patients Aged 40 Years and Older Demonstrate Durable and Comparable Results to Patients Aged Less Than 40 Years After Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Propensity Matched Study at Minimum 10-Year Follow-Up

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-09-01 DOI:10.1016/j.arthro.2024.01.004

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引用次数: 0

Abstract

Purpose

To compare clinical outcomes and rates of secondary surgery, including revision hip arthroscopy and conversion to total hip arthroplasty (THA), after primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients ≥40 years of age at minimum 10-year follow-up compared with a propensity-matched control group of patients <40 years.

Methods

A retrospective cohort study was performed for patients who underwent primary hip arthroscopy for FAIS between January 2012 and February 2013. Patients ≥40 years old were propensity matched in a 1:1 ratio by sex and body mass index to patients <40 years old. Patient-reported outcomes (PROs) including Hip Outcome Score for Activities of Daily Living and Sports-Specific subscales, modified Harris Hip, International Hip Outcome Tool–12, and Visual Analog Scale for Pain and Satisfaction were collected. Rates of minimal clinically important difference (MCID) and patient-acceptable symptomatic state (PASS) achievement at 10 years were evaluated and compared between groups. Rates of secondary surgery including revision hip arthroscopy and conversion to THA were evaluated. Gross survivorship between cohorts was evaluated using a Kaplan-Meier curve.

Results

Fifty-three patients aged ≥40 (age 48.3 ± 5.8 years) were successfully matched to 53 patients aged <40 (age: 28.9 ± 7.2, <0.001). There were no other preoperative group differences regarding patient demographics, characteristics, or radiographic findings. Both groups demonstrated significant improvement regarding all PROs at a minimum of 10 years’ follow-up (P < .001 for all). No significant difference was noted between cohorts regarding any delta (preoperative to 10-year postoperative) scores (P > .05 for all). High rates of MCID and PASS achievement were achieved in both cohorts, with no significant differences in any PRO measure (P > .05 for all). No significant differences in rates of complications (age ≥40: 2.0%, age <40: 7.7%, P = .363), rates of revision (age ≥40: 7.5%, age <40: 9.4%, P = .999), or conversion to THA (age ≥40: 13.2%, age <40: 3.8%, P = .161) were identified. On Kaplan-Meier analysis, no significant difference (P = .321) was demonstrated in overall gross survivorship between cohorts.

Conclusions

Patients with age ≥40 with FAIS undergoing primary hip arthroscopy demonstrated durable and comparable 10-year PRO and rates of MCID and PASS achievement compared with a propensity-matched cohort of age <40 counterparts.

Level of Evidence

Level III, retrospective comparative prognostic trial.

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年龄≥40 岁的患者与年龄＜40 岁的患者在接受股骨髋臼撞击综合征的初级髋关节镜手术后，可获得持久且相似的效果：至少 10 年随访的倾向匹配研究

目的本研究的目的是比较年龄≥40岁的股骨髋臼撞击综合征（FAIS）患者在接受初级髋关节镜手术后，与倾向匹配的对照组（年龄为40岁）患者相比，在至少10年的随访中的临床疗效和二次手术率，包括髋关节镜翻修手术和转为全髋关节置换术（THA）。方法对2012年1月至2013年2月期间因FAIS接受初级髋关节镜手术的患者进行回顾性队列研究。年龄≥40岁的患者与年龄<40岁的患者按性别和体重指数1:1的比例进行倾向匹配。收集的患者报告结果包括日常生活活动髋关节结果评分（HOS-ADL）和运动专项（HOS-SS）分量表、改良哈里斯髋关节（mHHS）、国际髋关节结果工具-12（iHOT-12）以及疼痛和满意度视觉模拟量表（VAS）。评估最小临床意义差异（MCID）和患者可接受症状状态（PASS）在 10 年后的达标率，并进行组间比较。评估了二次手术率，包括翻修髋关节镜手术和转为 THA 手术。结果53名年龄≥40岁的患者（年龄：48.3 ± 5.8岁）与53名年龄<40岁的患者（年龄：28.9 ± 7.2，<0.001）成功配对。术前两组患者在人口统计学、特征或放射学检查结果方面没有其他差异。两组患者在至少 10 年的所有 PROs 方面均有明显改善（均为 p<0.001）。各组间的任何 delta（术前至术后 10 年）评分均无明显差异（均为 p>0.05）。两组患者的 MCID 和 PASS 达标率都很高，在任何 PRO 指标上都没有明显差异（所有数据均为 0.05）。并发症发生率（年龄≥40：2.0%，年龄<40：7.7%，p=0.363）、翻修率（年龄≥40：7.5%，年龄<40：9.4%，p=0.999）或转为THA（年龄≥40：13.2%，年龄<40：3.8%，p=0.161）均无明显差异。结论年龄≥40岁的FAIS患者接受初级髋关节镜手术后，与倾向匹配的年龄<40岁的同类患者相比，其10年PRO、MCID和PASS达标率均表现出持久性和可比性。证据级别III级，回顾性比较预后试验

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.