Clinic for Orthopaedic Surgery, Luzerner Kantonsspital, CH-6004 Luzern, Switzerland.
J Bone Joint Surg Am. 2011 May;93 Suppl 2:66-9. doi: 10.2106/JBJS.J.01718.
Femoro-acetabular impingement can cause pain and degenerative changes of the hip joint. Traditionally, surgical dislocation of the hip joint has been performed for correction of pathologic abnormalities in the proximal part of the femur and the acetabulum. Failures of surgical treatment are often related to postoperative pain in the groin or in the area of the greater trochanter, associated with this surgical approach. The aim of our study was to determine the prevalence and functional impact of pain at the greater trochanter after surgical dislocation of the hip.
Fifty consecutive patients in whom femoro-acetabular impingement had been treated with surgical dislocation of the hip at our institution were seen for clinical and radiographic follow-up at one year. The Merle d'Aubigné score was calculated preoperatively and at the time of follow-up. Pain in the groin or at the greater trochanter during activity and at rest was recorded.
The mean Merle d'Aubigné score significantly improved from 14.4 points preoperatively to 17 points postoperatively. Preoperatively, eight patients (16%) had pain over the greater trochanter. At one year after surgery, twenty-three (46%) had such pain; these patients were primarily female (seventeen of the twenty-three). The mean Merle d'Aubigné score was 17.4 points for the patients without groin pain and 16.1 points for those with groin pain. The presence or absence of pain at the greater trochanter had no significant influence on the outcome, but groin pain was associated with inferior results.
Tenderness or pain over the greater trochanter is frequent after osteotomy of the greater trochanter and has a distinct female predominance. However, it has no significant negative influence on outcome. This is in contrast to groin pain, which is associated with inferior results.
股骨髋臼撞击症可引起髋关节疼痛和退行性改变。传统上，髋关节切开复位术用于纠正股骨近端和髋臼的病理异常。手术治疗失败通常与髋关节切开复位术后腹股沟或大转子区域的疼痛有关。我们的研究目的是确定髋关节切开复位术后大转子疼痛的发生率和对功能的影响。
在我们机构中，对 50 例股骨髋臼撞击症患者进行了髋关节切开复位术治疗，对这些患者进行了临床和影像学随访，随访时间为 1 年。术前和随访时计算 Merle d'Aubigné 评分。记录活动时和休息时腹股沟或大转子处的疼痛。
Merle d'Aubigné 评分从术前的 14.4 分显著提高到术后的 17 分。术前 8 例（16%）患者大转子处疼痛。术后 1 年，23 例（46%）患者出现大转子疼痛；这些患者主要为女性（23 例中有 17 例）。无腹股沟疼痛患者的 Merle d'Aubigné 评分为 17.4 分，有腹股沟疼痛患者的评分为 16.1 分。大转子处疼痛的存在与否对结果没有显著影响，但腹股沟疼痛与较差的结果相关。
大转子截骨术后大转子处压痛或疼痛较为常见，且以女性居多。然而，它对结果没有显著的负面影响。与腹股沟疼痛相反，腹股沟疼痛与较差的结果相关。
