Rate of Surgery and Baseline Characteristics Associated With Surgery Progression in Young Athletes With Prearthritic Hip Disorders.
Rate of Surgery and Baseline Characteristics Associated With Surgery Progression in Young Athletes With Prearthritic Hip Disorders.
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DOI：
10.1177/2325967120969863
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发表时间：
2020-11
影响因子：
2.6
通讯作者：
Cheng AL
中科院分区：
文献类型：
--
作者：
Collis RW;McCullough AB;Ng C;Prather H;Colditz GA;Clohisy JC;Cheng AL
关节炎前髋关节疾病（PAHD），如股骨髋臼撞击（FAI）、髋臼发育不良和髋臼唇撕裂，是青少年和年轻成年运动员疼痛和功能障碍的常见原因，尚未确定最佳的患者特异性治疗。手术治疗通常被推荐，但保守治疗可能是一些运动员的合理方法。确定（1）自我报告的患有PAHD的竞技运动员与非运动员之间进展为手术的相对比率，以及（2）在评估后1年内进行手术的运动员与未进行手术的运动员之间的基线人口统计学、疼痛和功能差异。队列研究;证据等级，3。对2015年6月22日至2018年5月1日期间在一家三级医疗学术医疗中心接受PAHD评估的初中、高中和大学患者进行了电子病历审查。提取的变量包括患者自我报告的运动员状态、评估后1年内选择手术的决定、基线自我报告的疼痛和患者报告结局测量信息系统（PROMIS）域的功能评分、髋关节残疾和骨关节炎结局评分（HOOS）以及改良的Harris髋关节评分。在260例合格患者（289例髋关节）中，203例患者（78%; 227例髋关节）为运动员。运动员选择手术的可能性并不比非运动员高（130/227髋[57%] vs 36/62髋[58%];相对风险[RR]，0.99 [95%CI，0.78-1.25]）。在运动员中，那些进行手术而不是保守治疗的人更有可能是女性（81% vs 69%; RR，1.34 [95% CI，0.98-1.83]），并且有更多已知的影像学异常（FAI：82% vs 69%，RR，1.47 [95% CI，1.09-1.99];发育不良：48% vs 27%，RR，1.44 [95% CI，1.16-1.79];混合畸形：30% vs 10%，RR，2.91 [95% CI，1.53-5.54];已知盂唇撕裂：84% vs 40%，RR，2.79 [95% CI，2.06-3.76]）。选择手术的运动员在所有HOOS子量表上也报告了更差的基线髋关节特异性症状（平均差异，10.8-17.7; P <0.01）。与非运动员相似，超过一半的PAHD运动员在评估后1年内选择了手术治疗。许多患有PAHD的竞技运动员继续保守治疗和推迟手术，但更多的结构性髋关节病理学和更严重的髋关节相关基线身体损伤与选择手术相关。
Prearthritic hip disorders (PAHD), such as femoroacetabular impingement (FAI), acetabular dysplasia, and acetabular labral tears, are a common cause of pain and dysfunction in adolescent and young adult athletes, and optimal patient-specific treatment has not been defined. Operative management is often recommended, but conservative management may be a reasonable approach for some athletes. To identify (1) the relative rate of progression to surgery in self-reported competitive athletes versus nonathletes with PAHD and (2) baseline demographic, pain, and functional differences between athletes who proceeded versus those who did not proceed to surgery within 1 year of evaluation. Cohort study; Level of evidence, 3. An electronic medical record review was performed of middle school, high school, and college patients who were evaluated for PAHD at a single tertiary-care academic medical center between June 22, 2015, and May 1, 2018. Extracted variables included patients’ self-reported athlete status, decision to choose surgery within 1 year of evaluation, and baseline self-reported pain and functional scores on Patient-Reported Outcomes Measurement Information System (PROMIS) domains, the Hip disability and Osteoarthritis Outcome Score (HOOS), and the modified Harris Hip Score. Of 260 eligible patients (289 hips), 203 patients (78%; 227 hips) were athletes. Athletes were no more likely to choose surgery than nonathletes (130/227 hips [57%] vs 36/62 hips [58%]; relative risk [RR], 0.99 [95% CI, 0.78-1.25]). Among athletes, those who proceeded to surgery over conservative care were more likely to be female (81% vs 69%; RR, 1.34 [95% CI, 0.98-1.83]) and had more known imaging abnormalities (FAI: 82% vs 69%, RR, 1.47 [95% CI, 1.09-1.99]; dysplasia: 48% vs 27%, RR, 1.44 [95% CI, 1.16-1.79]; mixed deformity: 30% vs 10%, RR, 2.91 [95% CI, 1.53-5.54]; known labral tear: 84% vs 40%, RR, 2.79 [95% CI, 2.06-3.76]). Athletes who chose surgery also reported worse baseline hip-specific symptoms on all HOOS subscales (mean difference, 10.8-17.7; P < .01 for all). Similar to nonathletes, just over half of athletes with PAHD chose surgical management within 1 year of evaluation. Many competitive athletes with PAHD continued with conservative management and deferred surgery, but more structural hip pathology and worse hip-related baseline physical impairment were associated with the choice to pursue surgery.
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DOI：
10.1186/s12969-016-0077-5
发表时间：
2016-03-11
期刊：
Pediatric rheumatology online journal
影响因子：
--
作者：
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影响因子：
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10.13063/2327-9214.1015
发表时间：
2013
期刊：
EGEMS (Washington, DC)
影响因子：
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作者：
Broderick JE;DeWitt EM;Rothrock N;Crane PK;Forrest CB
通讯作者：
Forrest CB
影响因子：
1.6
作者：
Jones, Graham;Hanton, Sheldon;Connaughton, Declan
通讯作者：
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影响因子：
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