Teddy Cheong, Xinyu Tao, Danyal H Nawabi, Hamid Rahmatullah Bin Abd Razak, Merrill Lee
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引用次数: 0
Abstract
Importance: In Asian populations, increased prevalence of hip dysplasia as well as activities of daily living which require increased hip range of motion, such as squatting, may impact outcomes of arthroscopic surgery for femoroacetabular impingement (FAI) when compared to their Western counterparts. Existing literature lacks a comprehensive review and synthesis of knowledge focusing on outcomes of arthroscopic intervention for FAI in the Asian population.
Objective: To conduct the first systematic review and meta-analysis that examines outcomes of arthroscopic intervention in Asian patients with FAI.
Evidence review: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus and Cochrane Library databases were reviewed. Case series or cohort studies assessing outcomes of arthroscopic intervention in FAI were included. Pooled analysis of modified Harris Hip Score (mHHS), Visual Analogue Scale (VAS) and adverse events were conducted. Rate of revision surgery and conversion to total hip arthroplasty (THA) were analysed as well.
Findings: Six studies (5 case series, 1 cohort study) of high methodological quality involving 498 patients were included. Age of patients ranged from 20s to 70s, with a balanced gender ratio. Pooled patient-reported outcomes improved significantly postoperatively. VAS at the last follow up mark improved by -4.28 (95% CI, -4.49 - -4.08, P < 0.00001) and VAS at the 12-month post-operation mark improved by -4.11 (95% CI, -4.34 - -3.88, P < 0.00001). The mHHS at the last follow up mark improved by 23.37 (95% CI, 20.29 - 26.45, P < 0.00001). Revision surgery rate was low at 2.8% and conversion to THA rate was 0.3%.
Conclusions and relevance: Arthroscopic intervention in FAI provides favourable outcomes in the Asian population that is comparable with outcomes seen in the Western population.
Level of evidence: Meta-analysis; Level of evidence, IV.
重要性：与西方人相比，亚洲人髋关节发育不良以及日常生活中需要增加髋关节活动范围的活动（如下蹲）的发病率增加，这可能会影响股骨髋臼撞击症（FAI）关节镜手术的疗效。现有文献缺乏对亚洲人股骨髋臼撞击症（FAI）关节镜手术治疗效果的全面回顾和知识综述：首次对亚洲 FAI 患者的关节镜干预效果进行系统回顾和荟萃分析：对 PubMed、Embase、Cumulative Index to Nursing and Allied Health Literature (CINAHL)、Scopus 和 Cochrane Library 等数据库进行了综述。纳入了评估关节镜干预治疗 FAI 效果的病例系列或队列研究。对改良哈里斯髋关节评分（mHHS）、视觉模拟量表（VAS）和不良事件进行了汇总分析。同时还分析了翻修手术率和转为全髋关节置换术（THA）率：共纳入六项方法学质量较高的研究（五项病例系列研究、一项队列研究），涉及 498 名患者。患者年龄从20多岁到70多岁不等，性别比例均衡。汇总的患者报告结果显示，术后效果明显改善。最后一次随访的VAS改善了-4.28（95% CI，-4.49 - -4.08，P < 0.00001），术后12个月的VAS改善了-4.11（95% CI，-4.34 - -3.88，P < 0.00001）。最后一次随访时，mHHS改善了23.37（95% CI，20.29 - 26.45，P < 0.00001）。翻修手术率较低，仅为2.8%，转为THA的手术率为0.3%：结论和相关性：关节镜干预治疗FAI在亚洲人群中取得了良好的疗效，与西方人群的疗效相当：证据级别：Meta分析；证据级别，IV。
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