Aprato Alessandro, Jayasekera Narlaka, Villar Richard N
The Richard Villar Practice, Spire Cambridge Lea Hospital, Impington, Cambridge, UK,
Knee Surg Sports Traumatol Arthrosc. 2014 Apr;22(4):932-7. doi: 10.1007/s00167-013-2373-7. Epub 2013 Jan 18.
This study describes the medium-term results of revision hip arthroscopy.
Patients with persistent hip pain and a positive impingement sign were considered for revision surgery after the exclusion of other causes of groin pain. Seventy-four consecutive patients were prospectively assessed using the modified Harris hip score for a period of 3 years after surgery. Of the 74 patients, 11 had inadequate follow-up data; thus, a total of 63 patients were qualified for the study. The mean age at index surgery was 37 years, comprising 27 males and 36 females.
Revision surgery was performed at a mean of 3 years from index surgery. Chondral lesion associated with labral re-injury was the most common finding at revision arthroscopy. In contrast to other authors, however, only 31 % of our patients underwent revision for persistent femoroacetabular impingement. The mean pre-operative mHHS for all 63 patients was 54 (SD 14.5). The mean post-operative mHHS was 53 (SD 14.9) at 6 weeks, 62 (SD 17.5) at 6 months, 63 (SD 16.5) at 1 year, 64 (SD 16.5) at 2 years and 59 (SD 16.5) at 3 years (p = n.s., 0.02, 0.045, 0.039 and n.s., respectively).
Revision arthroscopy results in improvement in outcome in the first 3 years after revision surgery with a success rate of 63.4 % at 1 year, falling to 55.6 % by 3 years.
本研究描述了髋关节翻修关节镜手术的中期结果。
在排除腹股沟疼痛的其他原因后，对持续存在髋关节疼痛且撞击征阳性的患者考虑进行翻修手术。连续74例患者在术后3年采用改良Harris髋关节评分进行前瞻性评估。74例患者中，11例随访数据不充分；因此，共有63例患者符合研究条件。初次手术时的平均年龄为37岁，其中男性27例，女性36例。
翻修手术平均在初次手术后3年进行。翻修关节镜检查最常见的发现是与盂唇再次损伤相关的软骨损伤。然而，与其他作者不同的是，我们的患者中只有31%因持续性股骨髋臼撞击而接受翻修。63例患者术前平均改良Harris髋关节评分为54分（标准差14.5）。术后6周平均改良Harris髋关节评分为53分（标准差14.9），6个月时为62分（标准差17.5），1年时为63分（标准差16.5），2年时为64分（标准差16.5），3年时为59分（标准差16.5）（p值分别为无统计学意义、0.02、0.045、0.039和无统计学意义）。
翻修关节镜手术在翻修术后的前3年可改善预后，1年成功率为63.4%，到3年时降至55.6%。
