Department of Orthopedic Surgery, Clínica Las Américas, Medellín, Columbia.
Arthroscopy. 2013 Aug;29(8):1308-13. doi: 10.1016/j.arthro.2013.05.002.
The purpose of this study was to evaluate whether the psoas tendon regenerates after arthroscopic tenotomy through the central compartment of the hip in patients with internal snapping hip.
Twenty-seven patients with a snapping hip, aged 18 to 54 years (mean, 37.47 years), underwent arthroscopic tenotomy through the central compartment of the hip; all patients had symptomatic femoroacetabular impingement as well. The degree of regeneration was evaluated by preoperative and postoperative measurements of the tendon perimeter with a magnetic resonance imaging protocol in patients with more than 6 months' follow-up. In addition, function was assessed preoperatively and postoperatively with the Western Ontario and McMaster Universities Osteoarthritis Index score. Postoperative active flexion force was graded clinically between 1 and 5 with the Medical Research Council score.
Eight patients had less than 6 months' follow-up, and they were excluded. The remaining 19 patients were evaluated after a mean follow-up period of 23.16 months (SD, 12.95 months). Tendon regeneration occurred in all patients. Compared with preoperative measurement, the psoas tendon circumference had recovered by 84.3% on average (55.44 ± 5.68 mm v 46.71 ± 6.05 mm, P < .001). Pain improved in all patients, and the mean Western Ontario and McMaster Universities Osteoarthritis Index score fell from 49 ± 15.9 points to 10.74 ± 11.35 points (P < .001). Muscle force recovered completely in all cases.
There is a process of tissular repair after psoas tenotomy, and the findings on magnetic resonance imaging suggest that tendon tissue regrowth occurs.
Level IV, therapeutic case series.
本研究旨在评估髋关节镜下经中央间隙切开术治疗弹响髋患者的腰大肌腱是否会再生。
27 例年龄 18 至 54 岁（平均 37.47 岁）的弹响髋患者接受了髋关节镜下经中央间隙切开术，所有患者均存在症状性股骨髋臼撞击症。对随访时间超过 6 个月的患者，通过术前和术后磁共振成像方案测量肌腱周长来评估再生程度。此外，采用 Western Ontario 和 McMaster 大学骨关节炎指数评分评估术前和术后的功能。术后通过 Medical Research Council 评分对主动屈曲力进行临床分级，分值范围为 1 至 5 分。
8 例患者的随访时间不足 6 个月，被排除在外。其余 19 例患者平均随访 23.16 个月（SD，12.95 个月）后进行了评估。所有患者均出现肌腱再生。与术前测量相比，腰大肌腱周长平均恢复了 84.3%（55.44 ± 5.68mm 比 46.71 ± 6.05mm，P <.001）。所有患者的疼痛均得到改善，Western Ontario 和 McMaster 大学骨关节炎指数评分均值从 49 ± 15.9 分降至 10.74 ± 11.35 分（P <.001）。所有病例的肌肉力量均完全恢复。
腰大肌腱切开术后存在组织修复过程，磁共振成像结果提示肌腱组织再生。
IV 级，治疗性病例系列。
