Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Arthroscopy. 2012 Sep;28(9):1255-61. doi: 10.1016/j.arthro.2012.02.006. Epub 2012 May 4.
The purpose of this study was to evaluate clinical outcomes after treatment for femoroacetabular impingement in the pediatric and adolescent population with a minimum of 2 years' follow-up.
Prospectively collected data on 60 consecutive pediatric and adolescent patients (65 hips), aged 16 years or younger, who underwent hip arthroscopy were retrospectively analyzed. Patients were excluded if they had previous surgery on the hip and if they presented a center-edge angle below 25°.
The mean age at the time of surgery was 15 years (range, 11 to 16 years), and 31% of patients were boys and 69% were girls. The femoral physis was open in 10% of patients, partially closed in 19%, and closed in 71%. Cam impingement was found in 10% of cases, pincer impingement in 15%, and mixed type in 75%. The mean center-edge angle was 36° (95% confidence interval [CI], 34° to 38°), and the mean alpha angle was 64° (95% CI, 60° to 69°). There was a significant association between age and alpha angle (r = 0.324, P = .02). After the index procedure, 8 patients (all girls) needed second-look diagnostic arthroscopies because of intra-articular adhesions. At a mean follow-up of 3 years (range, 2 to 5 years) with 91% follow-up, the modified Harris Hip Score increased from a mean of 57 (95% CI, 51 to 62) to a mean of 91 (95% CI, 88 to 94) (P < .001). The median rating for patient satisfaction with outcome was 10 (range, 5 to 10).
Hip arthroscopy in the pediatric and adolescent population is a safe procedure, with excellent clinical outcomes at 2 to 5 years. In this study there was an association between alpha angle and age. Clinical scores showed a significant improvement after surgery; however, 13% of patients did require a second procedure for capsulolabral adhesions.
Level IV, therapeutic case series.
本研究的目的是评估儿童和青少年髋关节撞击综合征患者经髋关节镜治疗后至少 2 年的临床结果。
回顾性分析了 60 例连续的儿童和青少年患者（65 髋）的前瞻性收集数据，这些患者年龄在 16 岁以下，接受了髋关节镜检查。如果患者髋关节有既往手术史或中心边缘角＜25°，则将其排除在外。
手术时的平均年龄为 15 岁（1116 岁），31%的患者为男性，69%为女性。10%的患者股骨骨骺未闭合，19%的患者部分闭合，71%的患者完全闭合。10%的病例存在凸轮撞击，15%的病例存在钳夹撞击，75%的病例存在混合型撞击。平均中心边缘角为 36°（95%置信区间，34°38°），平均α角为 64°（95%置信区间，60°69°）。年龄与α角之间存在显著相关性（r=0.324，P=0.02）。在指数手术后，由于关节内粘连，8 例患者（均为女性）需要进行第二次诊断性关节镜检查。在平均 3 年（25 年）的随访中，91%的患者获得了随访，改良 Harris 髋关节评分从平均 57（95%置信区间，5162）增加到平均 91（95%置信区间，8894）（P＜0.001）。患者对治疗结果满意度的中位数评分为 10（5~10）。
儿童和青少年髋关节镜检查是一种安全的手术方法，2~5 年的临床结果良好。在本研究中，α角与年龄之间存在相关性。手术后临床评分显著改善；然而，13%的患者需要进行第二次手术以松解关节囊和盂唇的粘连。
IV 级，治疗性病例系列研究。
