Outcome of hip arthroscopy is determined by diverse intrinsic and extrinsic factors in addition to capsular closure.

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Mo Saffarini, Sonia Ramos-Pascual, Alexis Nogier
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引用次数: 0

Abstract

There are contrasting findings between randomized controlled trials and systematic reviews that investigate capsular closure during arthroscopic treatment of femoroacetabular impingement syndrome (FAIS). Some surgeons advocate that capsular closure is beneficial, as it reduces risks of instability and degeneration, while others argue that capsular closure could lead to joint stiffness and/or fibrosis, in addition to increased surgical time. Although unrepaired periportal or interportal capsulotomies may (or may not) compromise outcomes, it is beneficial to close larger incisions and extensions of T-type capsulotomies, especially in patients with high risk of instability (concomitant borderline dysplasia, hyperlaxity, young age, etc.). Most studies focused on the effect of capsular closure do not identify other intrinsic and extrinsic factors-factors that could influence outcomes. Intrinsic factors include patient age, sex, type of FAIS (cam-, pincer-, or mixed-), Tönnis grade, and presence of concomitant hypermobility or dysplasia. Extrinsic factors include surgeon experience, surgical technique, adjuvant procedures (such as labral repair), as well as type of capsulotomy (periportal, interportal, T-type).

除关节囊闭合外,髋关节镜手术的结果还取决于各种内在和外在因素。
在关节镜治疗股髋臼撞击综合征(FAIS)过程中,随机对照试验和系统综述的研究结果截然不同。一些外科医生认为关闭关节囊是有益的,因为它降低了不稳定和退变的风险,而另一些人则认为,除了增加手术时间外,关闭关节囊还可能导致关节僵硬和/或纤维化。尽管未修复的门静脉周围或门静脉间囊切开术可能(也可能不会)影响预后,但关闭较大的切口和延长t型囊切开术是有益的,特别是对于不稳定风险高的患者(伴有边缘性发育不良、过度松弛、年轻等)。大多数研究关注的是囊膜闭合的效果,而没有发现其他可能影响结果的内在和外在因素。内在因素包括患者年龄、性别、FAIS类型(cam-、钳子-或混合型)、Tönnis分级以及是否伴有活动过度或发育不良。外在因素包括外科医生经验、手术技术、辅助手术(如唇部修复)以及囊膜切开术类型(门静脉周围、门静脉间、t型)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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