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关节镜下股骨成形术治疗凸轮型股骨髋臼撞击症

Arthroscopic femoroplasty in the management of cam-type femoroacetabular impingement.

作者信息

Byrd J W Thomas, Jones Kay S

机构信息

Nashville Sports Medicine Foundation, 2011 Church Street, Suite 100, Nashville, TN 37203, USA.

出版信息

Clin Orthop Relat Res. 2009 Mar;467(3):739-46. doi: 10.1007/s11999-008-0659-8. Epub 2008 Dec 19.

Abstract

Cam-type femoroacetabular impingement is a recognized cause of intraarticular pathology and secondary osteoarthritis in young adults. Arthroscopy is reportedly useful to treat selected hip abnormalities and has been proposed as a method of correcting underlying impingement. We report the outcomes of arthroscopic management of cam-type femoroacetabular impingement. We prospectively assessed all 200 patients (207 hips) who underwent arthroscopic correction of cam impingement from December 2003 to October 2007, using a modified Harris hip score. The minimum followup was 12 months (mean, 16 months; range, 12-24 months); no patients were lost to followup. The average age was 33 years with 138 men and 62 women. One hundred and fifty-eight patients (163 hips) underwent correction of cam impingement (femoroplasty) alone while 42 patients (44 hips) underwent concomitant correction of pincer impingement. The average increase in Harris hip score was 20 points; 0.5% converted to THA. We had a 1.5% complication rate. The short-term outcomes of arthroscopic treatment of cam-type femoroacetabular impingement are comparable to published reports for open methods with the advantage of a less invasive approach.

摘要

凸轮型股骨髋臼撞击症是年轻成人关节内病变和继发性骨关节炎的一个公认病因。据报道,关节镜检查对于治疗某些髋关节异常有用,并已被提议作为纠正潜在撞击的一种方法。我们报告凸轮型股骨髋臼撞击症的关节镜治疗结果。我们前瞻性评估了2003年12月至2007年10月期间接受凸轮撞击症关节镜矫正的所有200例患者(207髋),采用改良Harris髋关节评分。最短随访时间为12个月(平均16个月;范围12 - 24个月);无患者失访。平均年龄33岁,男性138例,女性62例。158例患者(163髋)仅接受凸轮撞击症矫正(股骨成形术),42例患者(44髋)同时接受钳夹型撞击症矫正。Harris髋关节评分平均提高20分;0.5%的患者转为接受全髋关节置换术。我们的并发症发生率为1.5%。凸轮型股骨髋臼撞击症关节镜治疗的短期结果与已发表的开放手术方法的报告相当,具有侵入性较小的优点。

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