Arthroscopic Treatment for Acetabular Labral Tears of the Hip Without Bony Dysmorphism
Arthroscopic Treatment for Acetabular Labral Tears of the Hip Without Bony Dysmorphism
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DOI：
10.1177/0363546511412915
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发表时间：
2011-07-01
影响因子：
4.8
通讯作者：
O'Donnell, John
中科院分区：
文献类型：
--
作者：
Haviv, Barak;O'Donnell, John
背景资料：髋关节盂唇撕裂的手术治疗在骨撞击病变患者中显示出良好的结果;然而，结果也受到骨异常矫正的影响。本研究评价了关节镜下治疗髋臼盂唇撕裂而无相关发育不良或骨撞击损伤的结果。假设：基于髋臼盂唇的结构重要性，盂唇撕裂清创或修复可以缓解疼痛并改善功能。研究设计：病例系列;证据等级，4。方法：本研究包括81例患者，根据4种形态学盂唇撕裂类型进行分类。采用多因素回归分析，分析撕裂类型、滑膜炎程度和软骨损伤与临床结局的相关性。结果：本组81例（81髋），男20例，女61例，其中右髋41髋，左髋40髋。他们的平均年龄是44岁。总体而言，在平均随访3年时，平均MHHS改善了18分（95%置信区间[CI]，13-23），平均NAHS改善了17分（95% CI，12-22）。关节镜治疗后，所有类型的髋关节盂唇撕裂均得到改善。滑膜炎和软骨病变的水平被发现有显着的负面影响的临床outcome.Conclusion：关节镜治疗髋臼唇撕裂的髋关节没有发育不良或骨撞击病变有良好的短期至中期的结果。最好的结果是在没有滑膜炎和软骨病变。
Background: Surgical treatment for labral tears of the hip has shown good results in patients with bony impingement lesions; however, results are also affected by the correction of bony abnormalities. This study evaluates the outcome of arthroscopic treatment for acetabular labral tears without associated dysplasia or bony impingement lesions.Hypothesis: Based on the structural importance of the acetabular labrum, labral tear debridement or repair can relieve pain and improve function.Study Design: Case series; Level of evidence, 4.Methods: The study included 81 patients who were categorized according to 4 morphologic labral tear types. The tear type, degree of synovitis, and chondral damage were analyzed with the use of multivariate regression analysis and correlated to the clinical outcome. The outcome was assessed utilizing the modified Harris hip score (MHHS) and the nonarthritic hip score (NAHS).Results: There were 81 patients (81 hips), including 20 men and 61 women, with 41 right and 40 left hips. Their mean age was 44 years. Overall, at an average follow-up of 3 years the mean MHHS had improved by 18 points (95% confidence interval [CI], 13-23) and the mean NAHS by 17 points (95% CI, 12-22). An improvement after arthroscopic treatment was noticed in all types of labral tears of the hip. The level of synovitis and of chondral lesions was found to have a significant negative effect on the clinical outcome.Conclusion: Arthroscopic treatment for acetabular labral tears of the hip without dysplasia or bony impingement lesions has good short- to midterm results. The best outcome is expected in the absence of synovitis and chondral lesions.