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手术髋关节脱位入路治疗青少年股骨髋臼撞击症的疗效。

Results of treatment of femoroacetabular impingement in adolescents with a surgical hip dislocation approach.

机构信息

Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.

出版信息

Clin Orthop Relat Res. 2013 Aug;471(8):2563-9. doi: 10.1007/s11999-013-3004-9. Epub 2013 May 8.

Abstract

BACKGROUND

The literature contains few studies of open treatment with an open surgical hip dislocation approach for treatment of femoroacetabular impingement (FAI) in adolescents. The average age and associated disorders in adolescents with FAI reveal a critical need to study younger patients whose hip disorder has not had time to progress.

QUESTIONS

We assessed (1) how validated measures of patient-oriented assessment of hip function and quality of life change after surgical hip dislocation; (2) whether any patient-related or technique variables correlated with changes in the outcome scores; and (3) what the complications of treatment are and how many reoperations we performed on these patients.

METHODS

We retrospectively reviewed a consecutive series of 71 hips in adolescents younger than 21 years who underwent surgical hip dislocation for FAI. The final cohort consisted of 44 patients (52 hips) with a mean age of 16 years. We analyzed changes in outcome variables after surgical hip dislocation and recorded reoperations during the study period.

RESULTS

The minimum followup was 12 months (average, 27 months; range, 12-60 months). Modified Harris hip scores increased from a mean of 57.7 preoperatively to a mean of 85.8 postoperatively. Mean SF-12 scores increased from 42.3 to 50.6. Mean preoperative hip flexion increased from 97.5° to 106.2°. Mean internal rotation of the affected hip at 90° flexion increased from 18.19° to 34°.

CONCLUSIONS

Early results revealed improvements in hip function, patient quality of life, and ROM after surgical hip dislocation for the majority of this group of adolescents with FAI. However, 10% of the patients did not improve, and an additional 15% improved but still did not consider their hips good or excellent. This points toward the need for further studies in this population of patients.

摘要

背景

文献中很少有研究采用开放式手术髋关节脱位入路治疗青少年股骨髋臼撞击症(FAI)。FAI 青少年的平均年龄和相关疾病表明,迫切需要研究年龄较小的患者,因为他们的髋关节疾病还没有时间进展。

问题

我们评估了(1)经过手术髋关节脱位治疗后,患者髋关节功能和生活质量的评估方法是否发生变化;(2)是否有任何与患者相关或技术相关的变量与结果评分的变化相关;(3)治疗的并发症是什么,我们对这些患者进行了多少次再手术。

方法

我们回顾性分析了 71 例年龄在 21 岁以下的青少年接受手术髋关节脱位治疗 FAI 的连续病例。最终队列包括 44 名患者(52 髋),平均年龄为 16 岁。我们分析了手术后髋关节脱位的结果变量变化,并记录了研究期间的再手术。

结果

最低随访时间为 12 个月(平均 27 个月;范围 12-60 个月)。改良 Harris 髋关节评分从术前的 57.7 分平均提高到术后的 85.8 分。SF-12 评分平均从 42.3 分增加到 50.6 分。术前髋关节屈曲平均增加 97.5°至 106.2°。在 90°屈曲时,受影响髋关节的内旋平均增加 18.19°至 34°。

结论

对于大多数患有 FAI 的青少年,手术后髋关节脱位可显著改善髋关节功能、患者生活质量和 ROM。然而,10%的患者没有改善,另外 15%的患者虽有改善,但仍认为自己的髋关节状况良好或优秀。这表明需要对这一患者群体进行进一步的研究。

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