髋关节镜治疗股骨髋臼撞击术后 10 年,发育不良患者的疗效和存活率与非发育不良患者相似。

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Karen Mullins, David Filan, Patrick Carton
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引用次数: 0

摘要

目的:与配对对照组相比,确定伴有外侧缘发育不良的股骨髋臼撞击症(FAI)患者接受髋关节镜手术(HA)的长期疗效:对2009年1月至2013年10月期间接受HA手术且随访至少10年的患者进行回顾性研究。纳入标准包括有外侧缘发育不良证据(LCEA为o)的髋关节镜治疗FAI患者。根据性别、Tonnis分级和年龄,将外侧缘发育不良的患者与LCEA>30o的患者进行配对。结果包括存活率(避免全髋关节置换术{THR})、重复髋关节置换术(repeat-HA)和患者报告的结果。存活率采用卡普兰-梅耶曲线和对数秩检验进行评估,组间翻修率采用卡普兰-梅耶曲线和对数秩检验进行评估,组间翻修率采用卡普兰-梅耶曲线和对数秩检验进行评估。PROs的组间和组内分析分别采用Mann Whitney U和Wilcoxon符号秩进行。采用卡方分析比较了组间达到患者可接受症状状态(PASS)的病例比例:报告了 46 例发育不良病例和 90 例对照病例。结果:共报告了 46 例发育不良病例和 90 例对照病例,除 LCEA 外,各组间基线指标无统计学差异(p 结论:髋关节镜手术治疗髋关节症状的效果非常好:髋关节镜治疗有症状的股骨髋臼撞击症(FAI)在发育不良的病例中是一种成功的治疗方法。并发症发生率低,疗效与无外侧缘发育不良的病例相当,且在至少10年的随访中存活率高达91%。术前增大Tonnis角可能会增加THR转换的风险:IV 回顾性队列研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patients With Dysplasia Achieve Similar Outcomes and Survivorship to Nondysplastic Patients 10 Years After Hip Arthroscopy for Femoroacetabular Impingement.

Purpose: To determine the long-term outcomes of hip arthroscopy (HA) for femoroacetabular impingement (FAI) in the presence of concomitant lateral rim dysplasia compared with a matched control group.

Methods: Patients undergoing HA between January 2009 and October 2013 with minimum 10-year follow-up were reviewed. The inclusion criteria consisted of patients undergoing HA for FAI with evidence of lateral rim dysplasia (lateral-center edge angle [LCEA] < 25°). Patients with lateral rim dysplasia were matched to patients with an LCEA greater than 30° based on sex, Tönnis grade, and age. Outcomes included survival (avoidance of total hip replacement [THR]), repeated HA, and patient-reported outcomes (PROs). Survivorship was assessed using a Kaplan-Meier curve and log rank test, whereas revision rates between groups were assessed using χ2 analysis. Between- and within-group analyses of PROs were conducted using the Mann-Whitney U test and Wilcoxon signed rank test, respectively. The proportion of cases achieving the patient acceptable symptom state was compared between groups using χ2 analysis.

Results: This study comprised 46 dysplasia cases and 90 control cases. There was no statistically significant difference between groups in baseline metrics apart from the LCEA (P < .001), Sharp angle (P < .001), and Tönnis angle (P < .001). By 10 years postoperatively, 9% of dysplasia cases and 4% of control cases underwent conversion to THR. There was no statistically significant difference between groups in survival or revision rates. Both groups reported improvements in PROs, and there was no difference between PRO scores at either time point. Excluding cases that underwent THR, 84% and 83% of dysplasia and control cases, respectively, achieved the patient acceptable symptom state.

Conclusions: HA for symptomatic FAI is a successful treatment in cases in which dysplasia is present. Low complication rates, comparable outcomes to cases without lateral rim dysplasia, and a high survivorship rate of 91% at minimum 10-year follow-up are observed. Increasing Tönnis angle preoperatively may increase the risk of THR conversion.

Level of evidence: Level IV, retrospective cohort study.

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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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