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发育异常情况下的髋关节镜检查

Hip arthroscopy in the presence of dysplasia.

作者信息

Byrd J W Thomas, Jones Kay S

机构信息

Nashville Sports Medicine & Orthopaedic Center, Nashville, Tennessee 37203, USA.

出版信息

Arthroscopy. 2003 Dec;19(10):1055-60. doi: 10.1016/j.arthro.2003.10.010.

Abstract

PURPOSE

Intra-articular pathology of the hip is often associated with dysplasia. The presence of dysplasia is often believed to be a harbinger of poor results for arthroscopy. The purpose of this study was to report the results of operative hip arthroscopy in conjunction with dysplastic disease of the hip.

TYPE OF STUDY

Prospective clinical case series.

METHODS

All patients undergoing hip arthroscopy are prospectively assessed with a modified Harris hip score performed preoperatively and postoperatively at 3, 12, 24, and 60 months. A minimum of 1-year follow-up has currently accumulated for 184 consecutive cases. The center edge (CE) angle of Wiberg is measured on the anteroposterior pelvis film and categorized as normal (> 25 degrees ), dysplastic (< 20 degrees ), or borderline dysplasia (20 degrees -25 degrees ).

RESULTS

In this study, 48 patients were identified with either dysplasia (16) or borderline dysplasia (32). At an average of 27 months, 100% follow-up was noted. For the dysplastic group, the average preoperative score was 57 and postoperative score was 83. For borderline dysplasia, the average preoperative score was 50 and postoperative score was 77. Statistically, no difference was found between the 2 groups. Collectively, the average improvement was 27 points, with 79% (38 patients) of patients showing at least a 10-point improvement.

CONCLUSIONS

The results of arthroscopy in the presence of dysplasia compare favorably with the general population previously reported. The response to treatment is probably dictated more by the nature of the intra-articular pathology rather than simply the presence or absence of radiographic evidence of dysplasia.

摘要

目的

髋关节的关节内病变常与发育异常相关。发育异常的存在通常被认为是关节镜手术效果不佳的先兆。本研究的目的是报告手术髋关节镜检查结合髋关节发育异常疾病的结果。

研究类型

前瞻性临床病例系列。

方法

对所有接受髋关节镜检查的患者进行前瞻性评估,术前以及术后3个月、12个月、24个月和60个月采用改良Harris髋关节评分。目前已连续积累了184例患者至少1年的随访资料。在骨盆前后位片上测量Wiberg中心边缘(CE)角,并分类为正常(>25度)、发育异常(<20度)或临界发育异常(20度-25度)。

结果

在本研究中,48例患者被确定为发育异常(16例)或临界发育异常(32例)。平均随访27个月,随访率为100%。发育异常组术前平均评分为57分,术后为83分。临界发育异常组术前平均评分为50分,术后为77分。统计学上,两组之间未发现差异。总体而言,平均改善27分,79%(38例)患者至少改善10分。

结论

发育异常情况下关节镜检查的结果与先前报道的一般人群相比具有优势。治疗反应可能更多地取决于关节内病变的性质,而不仅仅是发育异常的影像学证据的有无。

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