Factors Associated With the Failure of Surgical Treatment for Femoroacetabular Impingement: Review of the Literature.
Factors Associated With the Failure of Surgical Treatment for Femoroacetabular Impingement: Review of the Literature.
复制标题
DOI：
10.1177/0363546513500766
复制
发表时间：
2014-06
期刊：
影响因子：
--
通讯作者：
Katz JN
中科院分区：
文献类型：
--
作者：
Saadat E;Martin SD;Thornhill TS;Brownlee SA;Losina E;Katz JN
随着最近人们越来越多地认识到髋臼撞击(FAI)是髋关节疼痛和早期骨性关节炎的原因，外科治疗方法也越来越多。越来越多的文献报道了FAI的手术干预结果，但与不良手术结果相关的因素尚未得到系统综述。回顾现有文献，找出FAI开放手术或关节镜手术失败的相关因素。利用PubMed数据库检索1966年1月至2012年8月发表的相关英文文章。纳入标准主要集中在FAI的外科治疗、功能或疼痛结果的测量、治疗失败的识别以及导致失败的因素的统计分析。排除标准为综述文章、纯技术文献和非手术治疗研究。失败的两种定义被考虑：1)术后疼痛、功能或满意度的有效测量缺乏统计学上的显著改善，以及2)由于持续的症状而进行翻修手术或改行髋关节置换。所有研究都报告了术前变量和临床结果之间的一致性。共纳入13项研究。其中三个是回顾。没有随机对照试验。许多研究都有重要的方法局限性。术前软骨损伤或骨关节炎与髋关节置换术和疼痛或功能缺乏改善的关系最强烈和最一致。较大的指征手术年龄、较差的术前改良Harris髋关节评分和较长的术前症状持续时间(>；1.5年)与转行髋关节置换术相关。年龄较大、有关节炎改变、症状持续时间较长、术前疼痛和功能评分较差与FAI手术结果较差有关。将这些数据合并到与患者的讨论中，可能有助于就FAI的手术治疗做出知情的共享决策。
With the recent increased recognition of femoroacetabular impingement (FAI) as a cause of hip pain and early osteoarthritis, surgical treatment has proliferated. A growing body of literature reports on outcomes of surgical intervention for FAI, but factors associated with inferior surgical outcomes have not been reviewed systematically. To review available literature and identify factors associated with failure of open or arthroscopic surgery for FAI. Using the PubMed database, we searched for relevant English-language articles published from January 1966 through August 2012. Inclusion criteria were primary focus on surgical treatment of FAI, measurement of functional or pain outcomes, identification of treatment failures and statistical analysis of factors leading to failure. Exclusion criteria were review articles, technique-only articles and studies of nonoperative management. Two definitions of failure were considered: 1) lack of statistically signigicant improvement in validated measures of pain, function or satisfaction postoperatively, and 2) revision surgery or conversion to hip arthroplasty because of persistent symptoms. The consistency of association between preoperative variables and clinical outcomes was reported across all studies. Thirteen studies were included. Three were retrospective. There were no randomized controlled trials. Many studies had important methodological limitations. Preoperative cartilage damage or osteoarthritis had the strongest and most consistent relationship with conversion to hip arthroplasty and with lack of improvement in pain or function. Greater age at index operation, worse preoperative modified Harris Hip Score and longer duration of symptoms preoperatively (> 1.5 years) were associated with conversion to hip arthroplasty. Older age, the presence of arthritic changes, longer duration of symptoms and worse preoperative pain and functional scores are associated with poor outcomes of surgery for FAI. Incorporation of these data into discussions with patients may facilitate informed shared decision-making about surgical treatment of FAI.
登录
查看更多内容
影响因子：
4.2
作者：
Laude, Frederic;Sariali, Elhadi;Nogier, Alexis
通讯作者：
Nogier, Alexis
影响因子：
4.8
作者：
Larson, Christopher M.;Giveans, M. Russell;Stone, Rebecca M.
通讯作者：
Stone, Rebecca M.
影响因子：
4.2
作者：
Larson, Christopher M.;Giveans, M. Russell;Taylor, Mehul
通讯作者：
Taylor, Mehul
DOI：
10.1016/j.arthro.2008.12.014
发表时间：
2009-04-01
影响因子：
4.7
作者：
Larson, Christopher M.;Giveans, M. Russell
通讯作者：
Giveans, M. Russell
DOI：
10.1097/01.blo.0000096804.78689.c2
发表时间：
2003-12-01
影响因子：
4.2
作者：
Ganz, R;Parvizi, J;Siebenrock, KA
通讯作者：
Siebenrock, KA