Steadman Philippon Research Institute, Vail, Colorado 81657, USA.
Arthroscopy. 2012 Jan;28(1):59-65. doi: 10.1016/j.arthro.2011.07.004. Epub 2011 Oct 7.
The purpose of this study was to investigate outcomes after hip arthroscopy in a consecutive series of patients aged 50 years or older and determine how long patients avoided total hip replacement.
Between 2006 and 2008, prospectively collected data were retrieved from our database on 153 patients aged 50 years or older undergoing hip arthroscopy for femoroacetabular impingement. Data collected included range of motion, Modified Harris Hip Score (MHHS), Hip Outcome Score (HOS) for activities of daily living, HOS for sports, and Short Form 12 score. Survivors were defined as patients not requiring total hip replacement (THR). Survivorship was analyzed by use of the Kaplan-Meier method.
THR was required after the arthroscopic treatment in 20% of patients (31 of 153). At 3 years (with data available in 64 patients), patients with greater than 2 mm of joint space had survivorship of 90% whereas those with 2 mm or less had survivorship of 57% (P = .001). In the patients who did not require THR, the MHHS improved from 58 to 84. The HOS for activities of daily living improved from 66 to 87 (P = .001), and the HOS for sports improved from 42 to 72 (P = .001). The physical component of the Short Form 12 improved from 38 to 49 (P = .001), whereas the mental component did not change (54 preoperatively v 53 postoperatively, P = .53). Median patient satisfaction was 9.
On the basis of early results, patients with greater than 2 mm of joint space can expect improvement over preoperative status in pain and function after hip arthroscopy for femoroacetabular impingement. In patients aged 50 years or older with 2 mm of joint space or less and low preoperative MHHSs, early conversion to THR was seen.
Level IV, therapeutic case series.
本研究旨在对 50 岁及以上接受髋关节镜检查的连续患者系列的治疗结果进行调查，并确定患者避免全髋关节置换的时间。
在 2006 年至 2008 年期间，从我们的数据库中检索出 153 名 50 岁及以上因股骨髋臼撞击症接受髋关节镜检查的患者的前瞻性收集数据。收集的数据包括运动范围、改良 Harris 髋关节评分（MHHS）、日常生活活动的髋关节结局评分（HOS）、运动的髋关节结局评分（HOS）和 12 项简短健康调查量表（SF-12）评分。生存者定义为未接受全髋关节置换术（THR）的患者。采用 Kaplan-Meier 法分析生存率。
20%的患者（153 例中有 31 例）在关节镜治疗后需要进行 THR。在 3 年时（64 例患者有数据），关节间隙大于 2mm 的患者的生存率为 90%，而关节间隙为 2mm 或以下的患者的生存率为 57%（P=.001）。在未接受 THR 的患者中，MHHS 从 58 分提高到 84 分。日常生活活动的 HOS 从 66 分提高到 87 分（P=.001），运动的 HOS 从 42 分提高到 72 分（P=.001）。SF-12 的生理组成部分从 38 分提高到 49 分（P=.001），而心理组成部分没有变化（术前 54 分，术后 53 分，P=.53）。中位患者满意度为 9。
根据早期结果，髋关节镜检查治疗股骨髋臼撞击症的患者，关节间隙大于 2mm 者可预期疼痛和功能改善。对于关节间隙为 2mm 或以下且术前 MHHS 较低的 50 岁及以上患者，早期转换为 THR 。
IV 级，治疗性病例系列。
