Outcomes 2 to 5 Years Following Hip Arthroscopy for Femoroacetabular Impingement in the Patient Aged 11 to 16 Years
Outcomes 2 to 5 Years Following Hip Arthroscopy for Femoroacetabular Impingement in the Patient Aged 11 to 16 Years
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DOI：
10.1016/j.arthro.2012.02.006
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发表时间：
2012-09-01
影响因子：
4.7
通讯作者：
Briggs, Karen K.
中科院分区：
文献类型：
--
作者：
Philippon, Marc J.;Ejnisman, Leandro;Briggs, Karen K.
目的：本研究的目的是通过至少2年的随访，评估儿童和青少年髋臼撞击治疗后的临床结果。方法：对连续60例(65个髋关节)接受髋关节镜手术的16岁及以下的儿童和青少年患者的前瞻性资料进行回顾性分析。如果患者以前做过髋关节手术，并且中心边缘角度低于25度，则将其排除在外。结果：手术时平均年龄15岁(11~16岁)，其中31%为男孩，69%为女孩。10%的患者股骨骨赘开放，19%的患者部分关闭，71%的患者关闭。凸轮撞击占10%，钳形撞击占15%，混合型占75%。平均中心-边缘角为36度(95%可信区间，34度~38度)，平均α角为角(95%可信区间，60度~69度)。年龄与α角显著相关(r=0.324，P=0.02)。在指引术后，8名患者(均为女孩)因关节内粘连而需要进行第二次关节镜检查。平均随访3年(2~5年)，随访率为91%，改良Harris髋关节评分从平均57分(95%可信区间，51~62)增加到平均91分(95%可信区间，88~94)(P<；.001)。患者对结果满意程度的中位数为10(范围从5到10)。结论：髋关节镜在儿童和青少年人群中是一种安全的手术，在2-5年内具有良好的临床效果。在这项研究中，阿尔法角度和年龄之间存在关联。临床评分显示手术后有显著改善；然而，13%的患者确实需要第二次手术来治疗囊袋粘连。证据级别：IV级，治疗性病例系列。
Purpose: The purpose of this study was to evaluate clinical outcomes after treatment for femoroacetabular impingement in the pediatric and adolescent population with a minimum of 2 years' follow-up. Methods: Prospectively collected data on 60 consecutive pediatric and adolescent patients (65 hips), aged 16 years or younger, who underwent hip arthroscopy were retrospectively analyzed. Patients were excluded if they had previous surgery on the hip and if they presented a center-edge angle below 25 degrees. Results: The mean age at the time of surgery was 15 years (range, 11 to 16 years), and 31% of patients were boys and 69% were girls. The femoral physis was open in 10% of patients, partially closed in 19%, and closed in 71%. Cam impingement was found in 10% of cases, pincer impingement in 15%, and mixed type in 75%. The mean center-edge angle was 36 degrees (95% confidence interval [CI], 34 degrees to 38), and the mean alpha angle was 64 degrees (95% CI, 60 degrees to 69 degrees). There was a significant association between age and alpha angle (r = 0.324, P = .02). After the index procedure, 8 patients (all girls) needed second-look diagnostic arthroscopies because of intra-articular adhesions. At a mean follow-up of 3 years (range, 2 to 5 years) with 91% follow-up, the modified Harris Hip Score increased from a mean of 57 (95% CI, 51 to 62) to a mean of 91 (95% CI, 88 to 94) (P < .001). The median rating for patient satisfaction with outcome was 10 (range, 5 to 10). Conclusions: Hip arthroscopy in the pediatric and adolescent population is a safe procedure, with excellent clinical outcomes at 2 to 5 years. In this study there was an association between alpha angle and age. Clinical scores showed a significant improvement after surgery; however, 13% of patients did require a second procedure for capsulolabral adhesions. Level of Evidence: Level IV, therapeutic case series.