Stähelin Lisca, Stähelin Thomas, Jolles Brigitte M, Herzog Richard F
Hôpital Orthopédique de la Suisse Romande and University of Lausanne, Lausanne, Switzerland.
Arthroscopy. 2008 Jan;24(1):51-57.e1. doi: 10.1016/j.arthro.2007.08.010. Epub 2007 Nov 8.
The purpose of this study was to determine the accuracy of arthroscopic restoration of femoral offset as well as the early clinical outcome of arthroscopic debridement and femoral offset restoration and whether there is a correlation between accuracy and outcome.
Twenty-two patients with symptomatic femoroacetabular cam impingement underwent arthroscopic correction of the femoral offset and debridement. The alpha angle was measured with magnetic resonance imaging preoperatively and postoperatively for quantification of the offset, and the clinical status was determined by documenting the impingement sign, range of motion, intensity of pain on a visual analog scale, Nonarthritic Hip Score, and complications preoperatively and 6 months postoperatively.
The alpha angle improved from a mean of 75 degrees to 54 degrees. Internal rotation increased from a mean of 5 degrees to 22 degrees, flexion increased from a mean of 107 degrees to 124 degrees, and the pain score decreased from a mean of 5.8 to 1.4. The Nonarthritic Hip Score increased from a mean of 49 to 74 points. No major complications were encountered. Patients with early osteoarthritis did substantially worse than those without it. The alpha angle did not correlate with any clinical outcome measure.
The femoral offset can be precisely restored via an arthroscopic technique in the treatment of femoroacetabular cam impingement. The early clinical outcome of arthroscopic offset restoration and debridement is good in patients with no or only mild osteoarthritis. The accuracy of correction is not correlated with the early clinical outcome.
Level IV, therapeutic case series.
本研究旨在确定关节镜下恢复股骨偏心距的准确性，以及关节镜下清创和股骨偏心距恢复的早期临床结果，以及准确性与结果之间是否存在相关性。
22例有症状的股骨髋臼撞击症患者接受了关节镜下股骨偏心距矫正和清创术。术前和术后通过磁共振成像测量α角以量化偏心距，并通过记录撞击征、活动范围、视觉模拟量表上的疼痛强度、非关节炎髋关节评分以及术前和术后6个月的并发症来确定临床状况。
α角从平均75度改善至54度。内旋从平均5度增加到22度，屈曲从平均107度增加到124度，疼痛评分从平均5.8降至1.4。非关节炎髋关节评分从平均49分提高到74分。未出现重大并发症。早期骨关节炎患者的情况明显比无骨关节炎患者差。α角与任何临床结果指标均无相关性。
在治疗股骨髋臼撞击症时，可通过关节镜技术精确恢复股骨偏心距。对于无或仅有轻度骨关节炎的患者，关节镜下偏心距恢复和清创的早期临床结果良好。矫正的准确性与早期临床结果无关。
IV级，治疗性病例系列。
