Outcomes After Labral Repair in Patients With Femoroacetabular Impingement and Borderline Dysplasia
Outcomes After Labral Repair in Patients With Femoroacetabular Impingement and Borderline Dysplasia
复制标题
DOI：
10.1016/j.arthro.2015.06.028
复制
发表时间：
2015-12-01
影响因子：
4.7
通讯作者：
Philippon, Marc J.
中科院分区：
文献类型：
--
作者：
Fukui, Kiyokazu;Briggs, Karen K.;Philippon, Marc J.
目的：探讨边缘性发育不良合并股髋臼撞击（FAI）患者进行唇部修复后的预后。方法：选取2005年6月至2009年3月间接受治疗的非典型增生患者。本研究仅纳入年龄在18岁及以上（平均35岁，范围18 - 69岁）的患者，这些患者患髋关节的Wiberg中心边缘角为20 - 25度，并接受了由资深作者进行的初级髋关节镜检查。结果：102髋（100例患者，包括50名女性和50名男性）接受了髋关节镜检查，并进行了唇侧修复，纠正了FAI并关闭了关节囊。5个髋关节转为全髋关节置换术，7个髋关节需要翻修关节镜。在95名患者（代表100个髋关节，其中5个接受了全髋关节置换术）中，80名患者被监测了至少2年。在平均随访40个月时，术前改良的Harris髋关节评分从平均63.5分（范围，20至98分）提高到最新随访的平均84.9分（范围，45至100分）（P < 0.001）。西安大略省和麦克马斯特大学关节炎指数的平均得分从25.3（范围0至60）改善到9.7（范围0至59）（P < 0.001）。12项简短健康调查身体成分总结得分也有显著改善（从42.5到50.9,P = .001），而12项简短健康调查心理健康成分总结得分则没有显著改善（从52.4到54.1）。结论：本研究表明，在边缘性发育不良患者中，FAI和唇部病理可以通过髋关节镜和囊膜管理成功地控制。患者在髋关节镜检查后表现出明显的预后改善和高水平的满意度。后续手术的需要与仅FAI和唇部修复的患者相似。
Purpose: To determine outcomes after labral repair in patients with borderline dysplasia and femoroacetabular impingement (FAI). Methods: Patients with dysplasia treated between June 2005 and March 2009 were identified. The study included only patients aged 18 years or older (mean, 35 years; range, 18 to 69 years) whose affected hip had a Wiberg center-edge angle of 20 degrees to 25 degrees and who underwent primary hip arthroscopy performed by the senior author. Results: One hundred two hips (100 patients, comprising 50 women and 50 men) underwent hip arthroscopy with labral repair with correction of FAI and capsular closure. Five hips were converted to total hip arthroplasty, and 7 required revision arthroscopy. Of 95 patients (representing 100 hips, 5 of which underwent total hip arthroplasty), 80 were monitored for a minimum of 2 years. At a mean follow-up point of 40 months, the preoperative modified Harris Hip Score had improved from a mean of 63.5 points (range, 20 to 98 points) to a mean of 84.9 points (range, 45 to 100 points) by the latest follow-up (P < .001). The mean score on the Western Ontario and McMaster Universities Arthritis Index improved from 25.3 (range, 0 to 60) to 9.7 (range, 0 to 59) (P < .001). The 12-Item Short Form Health Survey Physical Component Summary score also significantly improved (from 42.5 to 50.9, P = .001), whereas the 12-Item Short Form Health Survey Mental Health Component Summary score showed an insignificant improvement (from 52.4 to 54.1). Conclusions: This study showed that FAI and labral pathology can be successfully managed using hip arthroscopy, with capsular management, in patients with borderline dysplasia. Patients showed significant improvements in outcomes and high levels of satisfaction after hip arthroscopy. The need for subsequent procedures was similar to that in patients with just FAI and labral repair.