Hip Arthroscopy with Labral Repair and Capsular Closure in Patients with Joint Hypermobility does not Result in Inferior Outcomes Compared to Patients without Joint Hypermobility.
Joseph J Ruzbarsky, Spencer M Comfort, Trevor J Shelton, Joan C Rutledge, Nicholas A Felan, Karen K Briggs, Grant J Dornan, Marc J Philippon
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引用次数: 0
Abstract
Purpose: To compare patient-reported outcomes (PROs) between patients with and without joint hypermobility following primary hip arthroscopy with labral repair for femoroacetabular impingement syndrome (FAIS).
Methods: Patients undergoing primary hip arthroscopy with labral repair for FAIS between January 2016 and December 2018 were identified. Exclusion criteria included prior ipsilateral hip surgery or center edge angle <20°. At minimum 2-year follow up, Hip Outcome Score (HOS) Activities of Daily Living (HOS-ADL) and Sport (HOS-Sport), modified Harris Hip Score (mHHS), 12-Item Short Form (SF-12) Physical and Mental Component Scores (PCS, MCS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), minimal clinically important difference (MCID), patient acceptable symptom states (PASS), Tegner Activity Scale, and satisfaction, were compared between hypermobility (HM) (Beighton score >5) and non-hypermobility (NHM) (Beighton score <5) groups.
Results: A total of 221 patients met the criteria, with 218 (98.6%) completing minimum follow-up. The HM group included 24 patients with mean follow-up of 4.18 ± 1.3 years, and the NHM group had 186 patients with mean follow-up of 5.21 ± 1.65 years. There were no significant differences in mean postoperative HOS-ADL (92±12 vs 87±19), HOS-Sport (81±24 vs 77±29), mHHS (87±14 vs 87±13), SF-12 PCS (53±8 vs 49±12), SF-12 MCS (54 ± 7 vs 54± 9), or WOMAC (9±11 vs 10±12) scores between NHM and HM groups, respectively (P>0.05). The NHM group attained MCID for HOS-ADL at a higher rate (P=0.04). No difference in PASS attainment for HOS-ADL or in PASS/MCID attainment for HOS-Sport or mHHS was observed (P>0.05). Median satisfaction was 8.50 (Range: 1-10) for HM and 10 (Range: 1-10) for NHM.
Conclusion: At minimum 2-year follow-up, PROs, reoperation, and THA rates were similar between patients with Beighton scores <5 and >5 undergoing hip arthroscopy with labral repair and capsular plication.
Level of evidence: Retrospective Comparative Case Series, III.
目的：比较患者报告的结果（PROs）在原发性髋关节镜下进行唇侧修复治疗股髋臼撞击综合征（FAIS）后，有和没有关节过度活动的患者。方法：对2016年1月至2018年12月期间接受原发性髋关节镜下唇侧修复治疗FAIS的患者进行分析。排除标准包括既往同侧髋关节手术或中心边缘角5)和非活动过度（NHM） （Beighton评分）。结果：共有221例患者符合标准，其中218例（98.6%）完成了最低随访。HM组24例，平均随访时间4.18±1.3年；NHM组186例，平均随访时间5.21±1.65年。NHM组与HM组术后平均HOS-ADL评分（92±12 vs 87±19）、HOS-Sport评分（81±24 vs 77±29）、mHHS评分（87±14 vs 87±13）、sf - 12pcs评分（53±8 vs 49±12）、sf - 12mcs评分（54±7 vs 54±9）、WOMAC评分（9±11 vs 10±12）差异均无统计学意义（P < 0.05）。NHM组达到HOS-ADL的MCID率更高（P=0.04）。HOS-ADL组的PASS、HOS-Sport组的PASS/MCID、mHHS组的PASS/MCID均无差异（P < 0.05）。HM的满意度中位数为8.50（范围：1-10），NHM的满意度中位数为10（范围：1-10）。结论：在至少2年的随访中，Beighton评分为5分的患者在进行唇部修复和囊膜应用的髋关节镜手术中，PROs、再手术和THA率相似。证据水平：回顾性比较病例系列，III。
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