Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK.
Arch Orthop Trauma Surg. 2012 Nov;132(11):1619-23. doi: 10.1007/s00402-012-1573-9. Epub 2012 Jul 5.
Tears of the abductor mechanism of the hip are well recognized, but poorly understood. Little is known of the effect of demographics and pathology on prevalence of abductor mechanism tears or the impact on clinical outcome.
This prospective study analysed the effect of age, gender, medical co-morbidity and social deprivation on prevalence of abductor mechanism tears of the hip in 835 consecutive patients undergoing total hip arthroplasty (THA) between 2003 and 2011. Effect on clinical outcome relating to presence of abductor mechanism tear was analysed in a subset at pre-op and at 1 year post-operation using the Oxford hip score (OHS).
The prevalence of abductor mechanism tears was 25.4 % (n = 212). Female patients (p < 0.001), older patients (p = 0.001) and those of lower socioeconomic status (p < 0.001) were significantly more likely to have a pre-operative abductor mechanism tear. In older socially deprived females the predicted rate of tear is 70.9 %. The aetiology of the hip disease (p = 0.593) or presence of any specific co-morbidity (p = 0.085-0.929) had no significant effect on the prevalence of abductor mechanism tears. In patients with protrusion or dysplasia there was an increased prevalence of tears (p = 0.002). There was no significant difference in pre-operative (p = 0.775) or post-operative (p = 0.604) OHSs regardless of the tears when the tears were recognized and treated at the time of THA.
Tears are increasingly prevalent in women of advancing years and lower socioeconomic status which should be considered when planning operative approach in this demographic. When recognised and repaired there is no difference in the clinical outcome for those with abductor mechanism tears of the hip.
髋关节外展机制的撕裂已经得到广泛的认识，但仍未被完全理解。关于人口统计学和病理学对髋关节外展机制撕裂的患病率的影响，以及对临床结果的影响，我们知之甚少。
本前瞻性研究分析了年龄、性别、合并症和社会贫困程度对 2003 年至 2011 年间 835 例连续接受全髋关节置换术（THA）患者髋关节外展机制撕裂患病率的影响。通过术前和术后 1 年的牛津髋关节评分（OHS），分析外展机制撕裂对临床结果的影响，该研究选择了一部分患者进行分析。
髋关节外展机制撕裂的患病率为 25.4%（n=212）。女性患者（p<0.001）、年龄较大的患者（p=0.001）和社会经济地位较低的患者（p<0.001）术前发生外展机制撕裂的可能性更大。在年龄较大、社会地位较低的女性中，撕裂的预测发生率为 70.9%。髋关节疾病的病因（p=0.593）或任何特定合并症的存在（p=0.085-0.929）对外展机制撕裂的患病率没有显著影响。在髋关节前突或发育不良的患者中，撕裂的发生率增加（p=0.002）。当在 THA 时识别和修复撕裂时，无论撕裂是否存在，患者的术前（p=0.775）或术后（p=0.604）OHS 均无显著差异。
在外展机制撕裂中，年龄较大的女性和社会经济地位较低的女性中撕裂的患病率逐渐增加，在考虑该人群的手术方法时应考虑到这一点。当识别和修复时，髋关节外展机制撕裂患者的临床结果没有差异。
