Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo, Rome, Italy.
Int Orthop. 2012 May;36(5):903-14. doi: 10.1007/s00264-011-1443-z. Epub 2011 Dec 22.
This review explores the scientific evidence for clinical, functional and imaging outcomes after surgical management of Femoroacetabular Impingement (FAI) syndrome, and assesses the methodological quality of the published literature reporting this issue.
The medical literature databases of Pubmed, Medline, Ovid, Google Scholar and Embase were searched for articles published in English, Spanish, French and Italian, using a combination of the keywords 'femoro-acetabular impingement syndrome', 'postoperative outcomes', 'open surgery', and 'arthroscopic management'. To address three main questions, we extracted data on demographic features, operative techniques, postoperative rehabilitation regimens, imaging features, pre and postoperative hip scores. Complications and conversion to arthroplasty were also investigated.
Thirty-one studies published have reported clinical, functional and imaging outcomes after open and arthroscopic management of FAI syndrome. The modified Coleman methodology score (CMS) averaged 56.2 (range, 30-81). From extracted data, it was shown that arthroscopy, open surgery and arthroscopic surgery followed by mini open surgery are comparable for functional results, biomechanics, and return to sport. Progression of OA and conversion to hip arthroplasty are dependent on preoperative status of cartilage and osteoarthritis and type of management. Debridement and osteoplasty provide better results than debridement only. Significantly improved outcomes have been recorded in patients undergoing labral refixation than resection. The Coleman methodology score showed great heterogeneity in terms of study design and outcome assessment, and generally low methodological quality.
Although open and minimally invasive procedures allow athletes to return to professional sports activity, they are contraindicated in patients with severe osteoarthritis and cartilage degeneration.
本综述探讨了髋关节撞击综合征（FAI）手术治疗后的临床、功能和影像学结果的科学证据，并评估了报告该问题的已发表文献的方法学质量。
使用“髋关节撞击综合征”、“术后结果”、“开放性手术”和“关节镜管理”等关键词，在 Pubmed、Medline、Ovid、Google Scholar 和 Embase 等医学文献数据库中搜索发表于英文、西班牙语、法语和意大利语的文章。为了解决三个主要问题，我们提取了关于人口统计学特征、手术技术、术后康复方案、影像学特征、术前和术后髋关节评分的数据。还研究了并发症和转为关节置换术的情况。
31 项已发表的研究报告了 FAI 综合征的开放性和关节镜治疗后的临床、功能和影像学结果。改良 Coleman 方法学评分（CMS）平均为 56.2（范围 30-81）。从提取的数据中可以看出，关节镜、开放性手术和关节镜手术后行小切口开放手术在功能结果、生物力学和重返运动方面具有可比性。OA 的进展和转为髋关节置换术取决于术前软骨和骨关节炎的状态以及管理类型。清创和骨成形术的效果优于单纯清创术。与切除相比，修复盂唇固定术可提供更好的结果。在接受盂唇修复术的患者中，记录到了显著改善的结果，而盂唇切除术的结果则较差。Coleman 方法学评分在研究设计和结果评估方面表现出很大的异质性，一般来说方法学质量较低。
尽管开放性和微创性手术允许运动员恢复专业运动活动，但在严重骨关节炎和软骨退化的患者中，这些手术是禁忌的。
