Odoom J E, Allen G M, Wilson D J
Department of Diagnostic Radiology, Nuffield Orthopaedic Centre, Oxford, UK.
Clin Radiol. 1999 Jul;54(7):430-3. doi: 10.1016/s0009-9260(99)90826-7.
To compare the outcome of hip therapy with the response to local anaesthetic into the hip.
A retrospective hip arthrographic study of 60 patients complaining of hip pain was performed. The average age of the patients was 58 +/- 20 years with ratio of men to women of 11:19. Thirty-eight of these patients underwent local anaesthetic intracapsular injection. Twenty-three (61%) obtained relief from pain whereas two (5%) experienced worsened pain.
Of the 23 patients who experienced pain relief 17 (74%) had a positive post-operative course, in comparison with eight (44%) who had a positive post-operative course from the group where intra-articular local anaesthetic was not used. It was also noted that patients over 30 years of age had favourable post-operative results in the presence or absence of local anaesthetic testing.
These results indicate that hip arthrography with a pain relieving intracapsular local anaesthetic injection, is a positive post-operative prognostic factor in a patient group of disparate disorders. A positive response to local anaesthetic injection into a hip may predict which patients are likely to respond well to surgery. We advise alterations to the consent procedure to add a warning concerning the small risk of increased hip pain. If further studies were to confirm our results it may be wise to recommend that local anaesthetic intracapsular injection and judgement of its efficacy should precede many surgical procedures involving the hip.
比较髋关节治疗效果与髋关节局部麻醉反应。
对60例主诉髋关节疼痛的患者进行回顾性髋关节造影研究。患者平均年龄为58±20岁，男女比例为11:19。其中38例患者接受了囊内局部麻醉注射。23例（61%）疼痛缓解，2例（5%）疼痛加重。
在疼痛缓解的23例患者中，17例（74%）术后病程良好，而未使用关节内局部麻醉的组中有8例（44%）术后病程良好。还注意到，无论是否进行局部麻醉测试，30岁以上患者术后结果良好。
这些结果表明，采用缓解疼痛的囊内局部麻醉注射进行髋关节造影，在一组不同疾病的患者中是术后预后的积极因素。髋关节局部麻醉注射的阳性反应可能预测哪些患者手术可能反应良好。我们建议修改知情同意程序，增加关于髋关节疼痛加重的小风险的警告。如果进一步的研究证实我们的结果，那么建议在许多涉及髋关节的手术之前先进行囊内局部麻醉注射并判断其疗效可能是明智的。
