Bardakos N V, Vasconcelos J C, Villar R N
The Richard Villar Practice The Wellington Hospital, London, England.
J Bone Joint Surg Br. 2008 Dec;90(12):1570-5. doi: 10.1302/0301-620X.90B12.21012.
There is a known association between femoroacetabular impingement and osteoarthritis of the hip. What is not known is whether arthroscopic excision of an impingement lesion can significantly improve a patient's symptoms. This study compares the results of hip arthroscopy for cam-type femoracetabular impingement in two groups of patients at one year. The study group comprised 24 patients (24 hips) with cam-type femoroacetabular impingement who underwent arthroscopic debridement with excision of their impingement lesion (osteoplasty). The control group comprised 47 patients (47 hips) who had arthroscopic debridement without excision of the impingement lesion. In both groups, the presence of femoroacetabular impingement was confirmed on pre-operative plain radiographs. The modified Harris hip score was used for evaluation pre-operatively and at one-year. Non-parametric tests were used for statistical analysis. A tendency towards a higher median post-operative modified Harris hip score was observed in the study group compared with the control group (83 vs 77, p = 0.11). There was a significantly higher proportion of patients in the osteoplasty group with excellent/good results compared with the controls (83% vs 60%, p = 0.043). Additional symptomatic improvement may be obtained after hip arthroscopy for femoroacetabular impingement by the inclusion of femoral osteoplasty.
股骨髋臼撞击症与髋关节骨关节炎之间存在已知的关联。尚不清楚的是，关节镜下切除撞击病变是否能显著改善患者症状。本研究比较了两组患者在术后一年时针对凸轮型股骨髋臼撞击症进行髋关节镜手术的结果。研究组包括24例（24髋）凸轮型股骨髋臼撞击症患者，他们接受了关节镜下清创并切除撞击病变（截骨成形术）。对照组包括47例（47髋）接受了关节镜下清创但未切除撞击病变的患者。两组患者术前的X线平片均证实存在股骨髋臼撞击症。采用改良Harris髋关节评分在术前及术后一年进行评估。采用非参数检验进行统计分析。与对照组相比，研究组术后改良Harris髋关节评分中位数有升高趋势（83分对77分，p = 0.11）。与对照组相比，截骨成形术组患者获得优/良结果的比例显著更高（83%对60%，p = 0.043）。对于股骨髋臼撞击症患者，髋关节镜手术中加用股骨截骨成形术可能会带来额外的症状改善。
