Department of Orthopaedic Surgery, Stanford University, Redwood City, California, U.S.A.
Arthroscopy. 2013 Nov;29(11):1777-82. doi: 10.1016/j.arthro.2013.08.003.
The purpose of this study was to evaluate 4 hips with symptomatic protrusio acetabuli treated arthroscopically for symptomatic pincer-type femoroacetabular impingement in 3 patients aged younger than 40 years.
Four hips in 3 patients, all active women, aged 26 to 37 years, with hip pain and radiographic evidence of protrusio acetabuli and a center-edge angle (CEA) of 50° or more, were studied and followed up for a minimum of 2.5 years. Each of these patients underwent arthroscopic anterior and lateral acetabuloplasty, partial labrectomy, synovectomy, and chondroplasty. Follow-up included evaluation with the modified Harris Hip Score (mHHS), radiographs, and clinical history and examination.
Patient 1 had bilateral hip surgeries. The right hip was followed up for 63 months, and the CEA improved from 67° to 60°, with an mHHS score improvement by 60.4 points. The CEA for the left hip improved from 63° to 53° at 61 months' follow-up, and the mHHS improved by 43.9 points. Both hips had a final mHHS of 100 points. Patient 3, followed up for 28 months, had a final mHHS of 100 points, 32 points better than preoperatively, whereas the CEA improved from 51° to 44°. Patient 3, a 26-year-old with preoperative radiographically apparent arthritis, had a final mHHS of 87 points, 35 points better than preoperatively, and the CEA improved from 50° to 42° at 32 months' follow-up. All 3 patients were happy with their outcomes.
In this small case series, arthroscopic acetabuloplasty showed reduced symptoms and improved function in 3 patients with protrusio aged younger than 40 years at a minimum of 2.5 years' follow-up.
Level IV, therapeutic case series.
本研究旨在评估 3 例年龄均小于 40 岁的有症状髋臼前突患者的 4 髋，这些患者均因症状性钳夹型股骨髋臼撞击征而行关节镜下治疗。
本研究共纳入 3 例有髋关节疼痛且影像学表现为髋臼前突和中心边缘角（CEA）大于 50°的患者，共 4 髋。这 3 例患者均为活跃女性，年龄 26~37 岁。所有患者均接受了关节镜下前侧和外侧髋臼成形术、部分髂腰肌切除术、滑膜切除术和软骨成形术。随访时采用改良 Harris 髋关节评分（mHHS）、影像学和临床病史及体格检查进行评估。
1 例患者行双侧髋关节手术。右侧髋关节随访 63 个月，CEA 从 67°改善至 60°，mHHS 评分改善 60.4 分。左侧髋关节在 61 个月随访时 CEA 从 63°改善至 53°，mHHS 评分改善 43.9 分。双侧髋关节的最终 mHHS 评分为 100 分。随访 28 个月的 3 号患者最终 mHHS 评分为 100 分，比术前提高 32 分，CEA 从 51°改善至 44°。3 号患者为 26 岁，术前影像学表现为关节炎，最终 mHHS 评分为 87 分，比术前提高 35 分，CEA 从 50°改善至 42°，随访 32 个月。3 例患者均对治疗结果感到满意。
在这项小病例系列研究中，关节镜下髋臼成形术在至少 2.5 年的随访中，缓解了 3 例年龄小于 40 岁的髋臼前突患者的症状，改善了功能。
IV 级，治疗性病例系列研究。
