Femoroacetabular Impingement Treatment Using Arthroscopy and Anterior Approach
Femoroacetabular Impingement Treatment Using Arthroscopy and Anterior Approach
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DOI：
10.1007/s11999-008-0656-y
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发表时间：
2009-03-01
影响因子：
4.2
通讯作者：
Nogier, Alexis
中科院分区：
文献类型：
--
作者：
Laude, Frederic;Sariali, Elhadi;Nogier, Alexis
股骨髋臼撞击（FAI）已被确定为年轻成人髋关节疼痛的常见原因。然而，治疗并不规范。我们回顾性分析了97例（100髋）在关节镜辅助下采用小切口前Hueter入路行股骨头颈骨软骨成形术治疗FAI的患者。患者的平均年龄为33.4岁。40髋关节盂唇重新固定，39例部分切除，14例完全切除，7例保持完整。6例患者失访，91例（94例髋关节）最短随访时间为28.6个月（平均58.3个月;范围28.6-104.4个月）。我们使用非关节炎髋关节评分（NAHS）对患者进行临床评估。1例患者术后3周发生股骨颈骨折。末次随访时，平均NAHS评分增加29.1分（术前54.8 +/- A 12分至末次随访时83.9 +/- A 16分）。11例髋关节发生骨关节炎，随后进行了全髋关节置换术。最好的结果是在年龄小于40岁的患者中获得的0 Tonnis等级。在末次随访时，盂唇再固定与较高的NAHS评分无关（再固定87 +/- A 11分，未再固定82 +/- A 19分）。FAI治疗的技术允许直接可视化的前股骨头颈交界处，同时避免手术脱位，并发症发生率低，并提高了功能scores.Level证据：II级，治疗研究。有关证据等级的完整描述，请参见作者指南。
Femoroacetabular impingement (FAI) has been identified as a common cause of hip pain in young adults. However, treatment is not well standardized. We retrospectively reviewed 97 patients (100 hips) who underwent osteochondroplasty of the femoral head-neck for FAI using a mini-open anterior Hueter approach with arthroscopic assistance. The mean age of the patients was 33.4 years. The labrum was refixed in 40 hips, partially excised in 39 cases, completely excised in 14 cases, and left intact in seven. Six patients were lost to followup, leaving 91 (94 hips) with a minimum followup of 28.6 months (mean, 58.3 months; range, 28.6-104.4 months). We assessed patients clinically using the nonarthritic hip score (NAHS). One patient had a femoral neck fracture 3 weeks postoperatively. At the last followup, the mean NAHS score increased by 29.1 points (54.8 +/- A 12 preoperatively to 83.9 +/- A 16 points at last followup). Eleven hips developed osteoarthritis and subsequently had total hip arthroplasty. The best results were obtained in patients younger than 40 years old with a 0 Tonnis grade. Refixation of the labrum did not correlate with a higher NAHS score (87 +/- A 11 with refixation versus 82 +/- A 19 points without) at the last followup. The technique for FAI treatment allowed direct visualization of the anterior femoral head-neck junction while avoiding surgical dislocation, had a low complication rate, and improved functional scores.Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.