Harvard Combined Orthopedic Residency Program, Boston, Massachusetts, USA.
Arthroscopy. 2012 Oct;28(10):1359-64. doi: 10.1016/j.arthro.2012.04.059. Epub 2012 Aug 17.
The purpose of this study was to perform a retrospective case-control outcome analysis at a minimum 2-year follow-up using a validated hip arthroscopy outcome measure to determine whether arthritis or age is predictive of outcomes after hip arthroscopy for labral pathology.
We identified 176 consecutive patients undergoing hip arthroscopy for labral tears performed between 2001 and 2009 to complete the Modified Harris Hip Score (MHHS) and Hip Outcome Score questionnaires. Patients who underwent additional surgeries or reported an MHHS of less than 80 were compared with the control group of patients who achieved good to excellent surgical results on the MHHS (>80) to calculate odds ratios with 95% confidence intervals by use of the independent variables of patient age of 40 years or older and age below 40 years and the presence of grade 4 Outerbridge changes found at arthroscopy.
Of 176 patients, 125 (71%) were contacted: 27 patients had undergone additional surgery in the follow-up period, and 98 completed questionnaires. The mean patient age at surgery was 40.9 years (range, 17.3 to 62.8 years) at a mean follow-up of 4.3 years (range, 2 to 10.4 years). Of 98 respondents, 71 (72%) obtained a good to excellent surgical outcome, with 84% reporting satisfaction. The presence of osteoarthritic changes at the time of arthroscopy was predictive of worse outcome scores compared with the nonarthritic cohort (odds ratio, 2.5; 95% confidence interval, 1.2 to 5.3; P = .02). Youth (age <40 years) is predictive of good to excellent results (odds ratio, 7; 95% confidence interval, 2.9 to 16.9; P < .0001).
Of the 98 patients who completed the questionnaires in this study, 71 (72%) obtained good to excellent outcome scores. Overall satisfaction among patients undergoing hip arthroscopy was high (84%). Patients aged younger than 40 years did better than older patients, and arthroscopically identified arthritis was predictive of worse surgical outcomes.
Level III, case-control study.
本研究通过使用经过验证的髋关节关节镜检查结果测量方法,对至少 2 年的随访进行回顾性病例对照结果分析,以确定关节炎或年龄是否可预测髋关节镜检查治疗盂唇病变的结果。
我们确定了 176 例连续接受髋关节镜检查治疗的患者,这些患者的盂唇撕裂发生在 2001 年至 2009 年之间,以完成改良 Harris 髋关节评分(MHHS)和髋关节评分问卷。将接受额外手术或报告 MHHS 评分低于 80 分的患者与 MHHS 评分>80 分的对照组患者进行比较,以计算使用独立变量(40 岁或以上患者年龄和<40 岁患者年龄)和关节镜下发现的 4 级 Outerbridge 变化存在的比值比和 95%置信区间。
在 176 例患者中,有 125 例(71%)接受了随访:27 例在随访期间接受了额外手术,98 例完成了问卷调查。手术时患者的平均年龄为 40.9 岁(范围 17.3 岁至 62.8 岁),平均随访时间为 4.3 年(范围 2 年至 10.4 年)。在 98 名应答者中,71 名(72%)获得了良好至优秀的手术结果,84%的人表示满意。与非关节炎组相比,关节镜下存在骨关节炎变化的患者的评分结果更差(比值比,2.5;95%置信区间,1.2 至 5.3;P =.02)。年轻(<40 岁)是获得良好至优秀结果的预测因素(比值比,7;95%置信区间,2.9 至 16.9;P <.0001)。
在本研究中完成问卷调查的 98 例患者中,71 例(72%)获得了良好至优秀的结果评分。接受髋关节关节镜手术的患者总体满意度很高(84%)。年龄小于 40 岁的患者比年龄较大的患者表现更好,关节镜下发现的关节炎是手术结果较差的预测因素。
III 级,病例对照研究。