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通过清创术和关节囊缝合术成功治疗孤立的、部分厚度的圆韧带(LT)撕裂。

Successful treatment of isolated, partial thickness ligamentum teres (LT) tears with debridement and capsulorrhaphy.

作者信息

Amenabar Tomas, O'Donnell John

机构信息

1 Instituto Traumatologico, Santiago - Chile.

出版信息

Hip Int. 2013 Nov-Dec;23(6):576-82. doi: 10.5301/hipint.5000072. Epub 2013 Aug 9.

Abstract

BACKGROUND

To determine if the addition of anterior capsular tightening to the treatment of partial ligamentum teres (LT) tears by debridement will diminish the recurrence rate of symptoms due to LT retears.

METHOD

A prospective case series, including all patients treated for an isolated LT tear from June 2009 to August 2011. Arthroscopically the tear was debrided using radiofrequency (RF) and the joint capsule was tightened using either RF or suture plication. All the patients were prospectively assessed with the Modified Harris Hip Score (MHHS) and the Non Arthritic Hip Score (NAHS). A total of 1574 hip arthroscopies were performed from June 2009 to November 2011. Isolated partial LT tears, were found in 27 hips (26 patients). The average age was 24.4 years (range 12-45). There were 24 females and two males.

RESULTS

Over an average follow-up period of 32 months (range 23-49), MHHS and NAHS preoperative outcome scores improved significantly. No revision surgery was required for a recurrent tear.

CONCLUSION

Debridement of partial thickness LT tears, with additional anterior capsule tightening, has been shown to lead to improvents in MHHS and NAHS, with no recurrence of symptoms due to LT retear in the short to medium term.

摘要

背景

确定在通过清创术治疗部分圆韧带(LT)撕裂时增加前囊收紧是否会降低因LT再次撕裂导致的症状复发率。

方法

一项前瞻性病例系列研究,纳入了2009年6月至2011年8月期间所有接受孤立性LT撕裂治疗的患者。在关节镜下,使用射频(RF)对撕裂处进行清创,并使用RF或缝合折叠术收紧关节囊。所有患者均采用改良Harris髋关节评分(MHHS)和非关节炎髋关节评分(NAHS)进行前瞻性评估。2009年6月至2011年11月共进行了1574例髋关节镜检查。在27个髋关节(26例患者)中发现了孤立性部分LT撕裂。平均年龄为24.4岁(范围12 - 45岁)。有24名女性和2名男性。

结果

在平均32个月(范围23 - 49个月)的随访期内,术前MHHS和NAHS结局评分显著改善。因再次撕裂无需进行翻修手术。

结论

部分厚度LT撕裂的清创术,外加前囊收紧,已被证明可使MHHS和NAHS得到改善,在短期至中期内不会因LT再次撕裂而出现症状复发。

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