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髋关节镜检查可改善特定青少年运动员的 FAI 相关症状。

Hip arthroscopy improves symptoms associated with FAI in selected adolescent athletes.

机构信息

Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.

出版信息

Clin Orthop Relat Res. 2012 Jan;470(1):261-9. doi: 10.1007/s11999-011-2015-7. Epub 2011 Aug 11.

Abstract

BACKGROUND

Femoroacetabular impingement (FAI) is increasingly diagnosed in young and middle-aged patients. Although arthroscopic procedures are becoming frequently used in the treatment of FAI, there are little data regarding rates of complications or the ability of hip arthroscopy to improve hip function specifically in the adolescent athlete population. Because arthroscopic treatment is being used in the treatment of FAI, it is vital to know what, if any, improvements in hip function can be expected and the potential complications.

QUESTIONS/PURPOSES: We asked (1) whether validated measures of hip function improve after arthroscopic treatment of FAI in adolescent athletes, and (2) what complications might be expected during and after arthroscopic treatment of FAI in these patients.

METHODS

We retrospectively reviewed the records of 27 hips in 21 patients 19 years of age or younger who underwent arthroscopic treatment for FAI between 2007 and 2008. From the records we extracted demographic data, operative details, complications, and preoperative and postoperative modified Harris hip scores (HHS) and the Hip Outcome Score (HOS). The minimum followup was 1 year (average, 1.5 years; range, 1-2.5 years).

RESULTS

Modified HHS improved by an average of 21 points, the activities of daily living subset of the HOS improved by an average of 16 points, and the sports outcome subset of the HOS improved by an average of 32 points. All patients' self-reported ability to engage in their preoperative level of athletic competition improved. In 24 hips that underwent cam decompression, the mean alpha-angle improved from 64° ± 16° to 40° ± 5.3° postoperatively.

CONCLUSIONS

We found short-term improvements in HOS and HHS with no complications for arthroscopic treatment of FAI in our cohort of adolescent athletes. We believe arthroscopic treatment of FAI by an experienced hip arthroscopist should be considered in selected patients when treating athletically active adolescents for whom nonoperative management fails.

摘要

背景

股骨髋臼撞击症(FAI)在年轻和中年患者中的诊断率越来越高。虽然关节镜手术在 FAI 的治疗中越来越常用,但关于并发症的发生率或髋关节镜检查对青少年运动员人群髋关节功能的改善能力的数据很少。由于关节镜治疗用于 FAI 的治疗,了解是否可以预期髋关节功能的任何改善以及潜在的并发症至关重要。

问题/目的:我们询问了(1)在青少年运动员中,关节镜治疗 FAI 后髋关节功能是否有改善,以及(2)在这些患者中,关节镜治疗 FAI 期间和之后可能出现哪些并发症。

方法

我们回顾性分析了 2007 年至 2008 年间接受关节镜治疗 FAI 的 21 名患者的 27 髋的记录。我们从记录中提取了人口统计学数据、手术细节、并发症以及术前和术后改良 Harris 髋关节评分(HHS)和髋关节结果评分(HOS)。最小随访时间为 1 年(平均随访时间为 1.5 年;范围为 1-2.5 年)。

结果

改良 HHS 平均改善 21 分,HOS 的日常生活活动部分平均改善 16 分,HOS 的运动结果部分平均改善 32 分。所有患者自我报告的参与术前运动水平的能力均有所提高。在 24 髋行凸轮减压术,平均α角从术前的 64°±16°改善至术后的 40°±5.3°。

结论

我们发现,在我们的青少年运动员队列中,关节镜治疗 FAI 可短期改善 HOS 和 HHS,且无并发症。我们认为,对于非手术治疗失败的活跃青少年运动员,应由经验丰富的髋关节镜医生选择关节镜治疗 FAI。

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