Successful return to sport in patients with symptomatic borderline dysplasia following hip arthroscopy and T-shaped capsular plication
Successful return to sport in patients with symptomatic borderline dysplasia following hip arthroscopy and T-shaped capsular plication
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DOI：
10.1007/s00167-020-06147-6
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发表时间：
2020-07-20
影响因子：
3.8
通讯作者：
Della Rocca, Federico
中科院分区：
文献类型：
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作者：
D'Ambrosi, Riccardo;Hantes, Michael Elias;Della Rocca, Federico
目的本研究旨在评估髋关节镜检查和T形关节囊折叠术后至少随访24个月的症状性边缘性髋关节发育不良（BHD）患者的运动恢复情况及其相关性。方法对25例有症状的BHD患者行髋关节镜下T形关节囊折叠术。所有患者均在术前（T-0）和两次连续随访时进行临床评估（T-1：15 +/- 1.2个月，T-2：53.9 +/-23.2个月），而运动活动通过髋关节结局评分运动特定子量表（HOS-SSS）、加州大学洛杉矶分校（UCLA）活动量表进行评估，Tegner评分和SF-12的身体成分（PCS）。此外，对亚组之间相关性的存在和可能的差异进行了评价和分析。结果HOS-SSS、VAS、Tegner、UCLA、PCS各时点重复测量结果经Friedman检验，差异有统计学意义（p < 0.0001）。此外，除T（1）和T-2（n.s.）之间的HOS-SSS外，所有评分均报告与前一时间点相比显著改善（p < 0.0001）。T-0时体重指数（BMI）与HOS-SSS呈负相关（rho =-0.526p = 0.006）和T-1（rho =-0.425;p = 0.034），每次随访时使用Tegner（T-0：rho =-0470p = 0.017; T-1：rho =-0.450;p = 0.024; T-2：rho =-0.448; p = 0.024），T-1时UCLA（rho =-0.396 p = 0.049），术前PCS（rho =-0.413 p = 0.0401），与术前VAS呈正相关（rho = 0.436 p = 0.0291）。结论髋关节镜检查和T形关节囊折叠术治疗有症状的年轻BHD患者在恢复运动和体力活动方面表现出显着的增加，并发症的风险较低。对于非手术治疗失败且运动活动明显受限的年轻活跃患者，可以考虑T形囊袋折叠术;对于这些患者，理想的治疗方法应可靠地允许快速恢复，同时具有非常低的侵入性，这将预防骨关节炎。这项研究的结果提供了关于髋关节镜和T形关节囊折叠术后BHD患者恢复运动的更准确的信息。
Purpose This study aims to evaluate the return to sport and correlations of patients with symptomatic borderline hip dysplasia (BHD) after hip arthroscopy and T-shaped capsular plication at a minimum follow-up of 24 months. Methods Twenty-five patients who underwent hip arthroscopy and T-shaped capsular plication for symptomatic BHD were included in the study. All the patients were evaluated clinically prior to surgery (T-0) and at two consecutive follow-ups (T-1:15 +/- 1.2 months and T-2: 53.9 +/- 23.2 months) using the visual analogue scale (VAS) pain score, whereas sports activity was assessed by the Hip Outcome Score Sport Specific Subscale (HOS-SSS), the University of California, Los Angeles (UCLA) activity scale, the Tegner score and the physical component (PCS) of the Short Form-12 (SF-12). Furthermore, the presence of correlations and the possible differences between subgroups were evaluated and analysed. Results A significant difference was found for HOS-SSS, VAS, Tegner, UCLA and PCS with the Friedman test for repeated measures through time points (p < 0.0001). Moreover, all the scores reported significant improvement compared to the previous time point (p < 0.0001) except the HOS-SSS between T(1)and T-2(n.s.). Body Mass Index (BMI) was negatively correlated with HOS-SSS at T-0(rho = - 0.526p = 0.006) and T-1(rho = - 0.425;p = 0.034), with Tegner at each follow-up (T-0: rho = - 0470p = 0.017; T-1: rho = - 0.450;p = 0.024; T-2: rho = - 0.448;p = 0.024), with UCLA at T-1(rho = - 0.396p = 0.049), with pre-operative PCS (rho = - 0.413p = 0.0401), and positively correlated with pre-operative VAS (rho = 0.436p = 0.0291). Conclusions Hip arthroscopy and T-shaped capsular plication in young patients with symptomatic BHD demonstrates a significant increase in return to sport and physical activity and low risk of complications. T-shaped capsular plication procedure may be considered in young and active patients for whom non-operative treatment failed and who have a significant limitation in sports activity; in these patterns of patients, the ideal treatment should reliably allow fast recovery in combination with very low invasiveness which will prevent osteoarthritis. The results of this study provide more accurate information regarding return to sport in patients with BHD after hip arthroscopy and T-shaped capsular plication.