Department of Orthopaedics, University of Zurich, Balgrist, Forchstr. 340, 8008 Zurich, Switzerland.
Arch Orthop Trauma Surg. 2013 Jan;133(1):69-79. doi: 10.1007/s00402-012-1616-2. Epub 2012 Oct 14.
Surgical hip dislocation (SHD) is an accepted standard to treat femoroacetabular impingement (FAI). However, arthroscopic techniques have gained widespread popularity and comparable results are reported. The purpose of this prospective comparative study was to test the hypothesis that, when compared to SHD, hip arthroscopy (HA) results in faster recovery, better short-term outcome, and equivalent morphological corrections.
38 patients presenting with clinically and morphologically verified isolated FAI were allocated to either HA or SHD. Morphological evaluation consisted of pre- and postoperative X-rays, and arthro-MRI. Demographic data, sport activities, hospital stay, complications, and the time off work were recorded. The subjective hip value, WOMAC, HHS, and hip abductor strength were measured up to 1 year.
Shorter hospital stay and time off work, less pain at 3 months and 1 year, higher subjective hip values at 6 weeks and 3 months, and better WOMAC at 3 months were seen after HA. The HHS and the hip abductor strengths were higher in the HA group. However, morphological corrections at the head-neck-junction achieved by HA showed some overcorrection when compared to SHD. Labral refixation was performed less frequent in the HA group.
When compared to SHD, HA results in faster recovery and better short-term outcome. However, some overcorrection of the cam deformity and limited frequency of labrum refixation with HA in this study may have a negative impact on long-term outcome.
手术髋关节脱位(SHD)是治疗股骨髋臼撞击症(FAI)的公认标准。然而,关节镜技术已经得到了广泛的普及,并且报告了类似的结果。本前瞻性对比研究的目的是验证以下假设:与 SHD 相比,髋关节镜(HA)可实现更快的康复、更好的短期结果和等效的形态学矫正。
38 名患有临床和形态学确诊的孤立性 FAI 的患者被分配到 HA 或 SHD 组。形态学评估包括术前和术后 X 射线以及关节 MRI。记录人口统计学数据、运动活动、住院时间、并发症和缺勤时间。主观髋关节评分、WOMAC、HHS 和髋关节外展肌力量在 1 年内进行测量。
HA 术后住院时间和缺勤时间更短,术后 3 个月和 1 年疼痛减轻,术后 6 周和 3 个月主观髋关节评分更高,术后 3 个月 WOMAC 评分更好。HA 组的 HHS 和髋关节外展肌力量更高。然而,与 SHD 相比,HA 矫正头颈部交界处的形态学畸形时存在一些过度矫正。HA 组的盂唇修复术频率较低。
与 SHD 相比,HA 可实现更快的康复和更好的短期结果。然而,本研究中 HA 矫正凸轮畸形存在过度矫正,以及盂唇修复术频率受限,可能对长期结果产生负面影响。