Beaulé Paul E, Le Duff Michel J, Zaragoza Edward
Division of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital General Campus, 501 Smyth Road, Suite 5004, Ottawa, ON K1H 8L6, Canada.
J Bone Joint Surg Am. 2007 Apr;89(4):773-9. doi: 10.2106/JBJS.F.00681.
Femoroacetabular impingement has been recently described as a common cause of hip pain and labral tears in young adults. We evaluated the early clinical results and quality of life after osteochondroplasty of the femoral head-neck junction for the treatment of femoroacetabular impingement.
Thirty-seven hips in thirty-four patients with persistent hip pain and a mean age of 40.5 years underwent surgical dislocation of the hip and osteochondroplasty of the femoral head-neck junction for the treatment of camtype femoroacetabular impingement. All of the patients had had preoperative evidence of pathological changes in the labrum on imaging. The clinical course and the quality of life were assessed postoperatively.
The mean score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) increased from 61.2 points preoperatively to 81.4 points at a mean of 3.1 years postoperatively (p < 0.001), the mean University of California at Los Angeles (UCLA) activity score increased from 4.8 to 7.5 points (p < 0.001), the mean Short Form-12 (SF-12) physical component score increased from 37.3 to 45.6 points (p < 0.001), and the mean SF-12 mental component score increased from 46.4 to 51.2 points (p = 0.031). None of the hips underwent additional reconstructive surgery. There were no cases of osteonecrosis. Nine patients underwent screw removal from the greater trochanter because of persistent bursitis. Six of the thirty-four patients were dissatisfied with the outcome.
Cam-type femoroacetabular impingement is associated with insufficient concavity at the anterolateral head-neck junction and with pathological changes in the labrum. Osteochondroplasty of the femoral head-neck junction following surgical dislocation of the hip joint is safe and effective and can provide a significant improvement in the overall quality of life of most patients.
Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
股骨髋臼撞击症最近被认为是年轻成人髋关节疼痛和盂唇撕裂的常见原因。我们评估了股骨头颈交界处骨软骨成形术治疗股骨髋臼撞击症后的早期临床结果和生活质量。
34例持续髋关节疼痛、平均年龄40.5岁的患者共37髋，接受了髋关节手术脱位及股骨头颈交界处骨软骨成形术，以治疗凸轮型股骨髋臼撞击症。所有患者术前影像学检查均有盂唇病理改变的证据。术后对临床病程和生活质量进行了评估。
西安大略和麦克马斯特大学骨关节炎指数（WOMAC）平均得分从术前的61.2分提高到术后平均3.1年时的81.4分（p < 0.001），加利福尼亚大学洛杉矶分校（UCLA）活动评分平均从4.8分提高到7.5分（p < 0.001），简明健康调查量表（SF - 12）身体成分评分平均从37.3分提高到45.6分（p < 0.001），SF - 12精神成分评分平均从46.4分提高到51.2分（p = 0.031）。无一例髋关节接受额外的重建手术。无骨坏死病例。9例患者因持续性滑囊炎接受了大转子螺钉取出术。34例患者中有6例对结果不满意。
凸轮型股骨髋臼撞击症与股骨头颈交界处前外侧凹陷不足及盂唇病理改变有关。髋关节手术脱位后进行股骨头颈交界处骨软骨成形术安全有效，可显著改善大多数患者生活质量。
治疗性IV级。有关证据水平的完整描述，请参阅作者须知。
