臀中肌腱修复的迷你开放技术并发症发生率低，两年随访后患者报告结果持续改善

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-10-01 DOI:10.1016/j.asmr.2024.100972

Matthew Quinn M.D. , Alex Albright M.D. , Victoria Kent B.S. , Patrick Morrissey M.D. , Luca Katz B.S. , Michael Kutschke M.D. , Nicholas Lemme M.D. , Ramin R. Tabaddor M.D.

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引用次数: 0

摘要

目的评估资深作者的混合 "小开腹 "技术用于内收肌腱修复的疗效（随访 2 年）。方法经机构审查委员会批准后，我们对 2018 年 1 月至 2022 年 1 月期间接受孤立小开腹臀中肌腱修复术的所有患者的前瞻性数据进行了回顾性审查。纳入标准包括非手术治疗难治的持续内收肌疼痛、磁共振成像显示臀中肌/臀肌腱撕裂、完成术前患者报告结果测量（PROMs），包括改良哈里斯髋关节评分（mHHS）、日常生活活动髋关节结果评分（HOS-ADL）、运动相关活动髋关节结果评分（HOS-SS）和疼痛视觉模拟量表（VAS），以及至少 2 年的随访。PROM分别在术前、术后6个月、1年和2年进行评估。采用配对样本 t 检验比较各结果指标的变化。结果共纳入 61 名患者（59 名女性，96.7%），平均年龄（61.4 ± 1.3）岁。mHHS 从术前的平均 47.2 改善到 2 年后的 68.9（P < 0.001），HOS-ADL 从 54 改善到 78.9（P < 0.001），HOS-SS 从 37 改善到 66.5（P = 0.015），VAS 从 13.3 改善到 7.4（P = 0.001）。mHHS、HOS-ADL、HOS-SS 和 VAS 的 MCID 分别为 11.1（达到 60%）、6.1（达到 78.6%）、9.7（达到 80.3%）和 14.5（达到 75.4%）。结论在一名外科医生的临床实践中，内收肌肌腱修复的小开腹技术在2年随访时可持续改善疼痛和功能相关的PROM，并发症发生率与内窥镜和开腹技术相当。

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Mini-Open Technique for Gluteus Medius Tendon Repairs Is Associated With Low Complication Rates and Sustained Improvement in Patient Reported Outcomes at 2-Year Follow-Up

Purpose

To evaluate the efficacy of the senior author’s hybrid “mini-open” technique for abductor tendon repair at 2-year follow-up.

Methods

After institutional review board approval, we performed a retrospective review of prospectively collected data for all patients undergoing isolated mini-open gluteus medius tendon repairs from January 2018 to January 2022. Inclusion criteria included ongoing abductor pain refractory to nonoperative management, magnetic resonance imaging demonstrating gluteus medius/minimus tear, completion of preoperative patient-reported outcome measures (PROMs) including Modified Harris Hip Score (mHHS), Hip Outcome Score for Activities of Daily Living (HOS-ADL), Hip Outcome Score for Sports-Related Activities (HOS-SS), and visual analog scale (VAS) for pain and minimum 2-year follow-up. PROMs were assessed at preoperative, 6-month, 1-year, and 2-year postoperative intervals. Paired-sample t tests were used to compare the change in each outcome measure. The minimal clinically important difference (MCID) was calculated, and complications were recorded.

Results

Sixty-one patients (59 female, 96.7%) with an average age of 61.4 ± 1.3 years were included. The mean follow-up was 25.9 ± 1.13 months. mHHS improved from a mean of 47.2 preoperatively to 68.9 at 2 years (P < 0.001), HOS-ADL from 54 to 78.9 (P < 0.001), HOS-SS from 37 to 66.5 (P = 0.015), and VAS from 13.3 to 7.4 (P = 0.001). The MCIDs for mHHS, HOS-ADL, HOS-SS, and VAS were 11.1 (60% achievement), 6.1 (78.6% achievement), 9.7 (80.3% achievement), and 14.5 (75.4% achievement), respectively. Two patients experienced retears (3.2%), with no other complications reported.

Conclusions

The mini-open technique for abductor tendon repair provides sustained improvement in both pain and function-related PROMs at 2-year follow-up with comparable complication rates to endoscopic and open techniques in 1 surgeon’s practice.