Tran Phong, Pritchard Michael, O'Donnell John
Orthopaedic Surgery, Western Health, Footscray, Victoria, Australia.
ANZ J Surg. 2013 May;83(5):382-6. doi: 10.1111/j.1445-2197.2012.06197.x. Epub 2012 Sep 3.
Hip arthroscopy has become an established procedure in adults with well-published results. These techniques have been extended to the teenage population, but the literature remains limited in regard to indications, efficacy, outcomes and complications specific to the paediatric population.
HYPOTHESIS/PURPOSE: The purpose of this study was to report the short-term outcome of the arthroscopic treatment of cam-type femoroacetabular impingement (FAI) in the skeletally immature adolescent population with open growth plates, with the hypothesis that it is a safe procedure, with good clinical outcomes and low complication rates.
The study design of this article was a multicentre prospective longitudinal case series.
From 2008-2009, 34 consecutive patients who were 18 years or younger at the date of operation (41 hips) with open proximal femoral growth plates had arthroscopic hip surgery for treatment of cam-type FAI and associated lesions by use of the lateral decubitus position by two surgeons. Data were collected prospectively including the modified Harris hip score (MHHS), nonarthritic hip score (NAHS), satisfaction survey and complications. Mean follow-up was 14 months (range 1-2 years).
All hips were available for review. The mean age of patients was 15.7 years with the most common sport activity being Australian Football League, netball and rugby. All patients had cam-type impingement, with the most common associated lesions being acetabular rim lesions (82.9%) and pincer impingement (22%). The labrum underwent debridement in 31.7% of cases, and was repaired in 17.1%. The MHHS and NAHS improved in all patients post-operatively, 77.39-94.15 and 76.34-93.18, respectively. A percentage of 78.1 were able to return to full sporting activity and 88.2% were satisfied with the operation. There were no complications.
Using hip arthroscopy to treat cam-type impingement and associated lesions in the adolescent population, we confirmed our hypothesis with observed high satisfaction levels, return to sports, significant improvement in post-operative hip scores (MHHS and NAHS) and no complications.
髋关节镜检查已成为一种成熟的手术方法，在成人中的应用成果已广泛发表。这些技术已扩展至青少年人群，但关于儿科人群特有的适应症、疗效、结果和并发症的文献仍然有限。
假设/目的：本研究的目的是报告关节镜治疗骨骼未成熟、生长板开放的青少年人群中凸轮型股骨髋臼撞击症（FAI）的短期结果，假设该手术安全，临床效果良好且并发症发生率低。
本文的研究设计是多中心前瞻性纵向病例系列。
2008年至2009年，34例手术时年龄18岁及以下、股骨近端生长板开放的连续患者（41髋）接受了关节镜髋关节手术，由两名外科医生采用侧卧位治疗凸轮型FAI及相关病变。前瞻性收集数据，包括改良Harris髋关节评分（MHHS）、非关节炎髋关节评分（NAHS）、满意度调查和并发症情况。平均随访14个月（范围1至2年）。
所有髋关节均可供复查。患者平均年龄15.7岁，最常见的体育活动是澳大利亚足球联赛、无挡板篮球和橄榄球。所有患者均有凸轮型撞击症，最常见的相关病变是髋臼边缘病变（82.9%）和钳夹型撞击症（22%）。31.7%的病例进行了盂唇清创术，17.1%进行了修复。所有患者术后MHHS和NAHS均有改善，分别从77.39提高到94.15，从76.34提高到93.18。78.1%的患者能够恢复全面体育活动，88.2%的患者对手术满意。无并发症发生。
使用髋关节镜治疗青少年人群中的凸轮型撞击症及相关病变，我们通过观察到的高满意度、恢复运动能力、术后髋关节评分（MHHS和NAHS）显著改善且无并发症，证实了我们的假设。
