Division of Sports Medicine and Hip Preservation, Department of Orthopaedics, University of Colorado School of Medicine, Boulder, Colorado, U.S.A..
Millennium Institute of Sport and Health, North Shore City, New Zealand.
Arthroscopy. 2014 Jan;30(1):47-54. doi: 10.1016/j.arthro.2013.09.079. Epub 2013 Nov 14.
The purpose of this study was to investigate whether, in patients with bilateral symptomatic femoroacetabular impingement, bilateral surgery under 1 anesthetic is safe and efficacious and allows a rapid return of function compared with staged procedures.
Three groups were evaluated: in group 1 both hips were treated simultaneously, in group 2 both hips were treated in a staged fashion, and in group 3 a single hip was addressed. The outcome measures were anesthesia and surgical times; time in the hospital; visual analog scale score for pain on postoperative days 1, 3, 7, and 30; analgesic use; and time until the patient could bike, drive, perform office work, perform gym activities, run, and return to play. Midterm evaluation was performed with the Non-Arthritic Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index score at 6 and 12 months postoperatively.
We enrolled 76 patients (122 hips) in this study. There were 42 male and 34 female patients. The mean age was 33 years (range, 14 to 50 years), and the mean body mass index was 24 (range, 18 to 35). Group 1 comprised 26 patients (52 hips, 16 male and 10 female patients). Group 2 comprised 20 patients (40 hips, 13 male and 7 female patients), with a mean time between surgeries of 14.56 weeks. Group 3 comprised 33 patients (30 hips, 13 male and 17 female patients). No preoperative differences were found between the groups. The surgical and anesthesia times in group 1 were significantly longer than those in groups 2 and 3. We found no significant differences in postoperative visual analog scale scores, analgesic use, or length of hospital stay. Group 1 required more time before patients were able to ride a stationary bicycle (14.7 days in group 1, 7.8 days in group 2, and 8.5 days in group 3; P < .05). We found no differences between the groups regarding when patients returned to driving, performing office work, or reporting a normal gait. Each group had significant improvements in the Western Ontario and McMaster Universities Osteoarthritis Index and Non-Arthritic Hip Score at 6 and 12 months compared with preoperatively (P < .05). No significant differences in outcome scores were found in the 3 groups before surgery and at 6 or 12 months after surgery.
Simultaneous femoroacetabular impingement surgery does not lead to higher rates of complications, postoperative pain, analgesic use, or side effects. The return to daily activities is similar to a single-hip procedure with the advantage of a single rehabilitation.
Level III, retrospective comparative study.
本研究旨在探讨对于双侧症状性股骨髋臼撞击症患者，同期双侧手术是否安全有效，并能与分期手术相比更快地恢复功能。
评估了三组：第 1 组双侧髋关节同期治疗，第 2 组双侧髋关节分期治疗，第 3 组单侧髋关节治疗。观察指标为麻醉和手术时间、住院时间、术后第 1、3、7、30 天疼痛视觉模拟评分、镇痛药物使用情况以及患者能够骑自行车、开车、办公、进行健身房活动、跑步和恢复运动的时间。术后 6 个月和 12 个月时采用非关节炎髋关节评分和西安大略和麦克马斯特大学骨关节炎指数评分进行中期评估。
本研究共纳入 76 例患者（122 髋）。其中男性 42 例，女性 34 例。患者平均年龄为 33 岁（范围：14-50 岁），平均体重指数为 24（范围：18-35）。第 1 组包括 26 例患者（52 髋，16 例男性，10 例女性）。第 2 组包括 20 例患者（40 髋，13 例男性，7 例女性），两次手术之间的平均间隔时间为 14.56 周。第 3 组包括 33 例患者（30 髋，13 例男性，17 例女性）。各组之间术前无显著差异。第 1 组的手术和麻醉时间明显长于第 2 组和第 3 组。我们发现术后视觉模拟评分、镇痛药物使用或住院时间无显著差异。第 1 组患者能够骑固定自行车的时间更长（第 1 组为 14.7 天，第 2 组为 7.8 天，第 3 组为 8.5 天；P<0.05）。我们发现各组在能够开车、办公或报告正常步态方面没有差异。与术前相比，每组在术后 6 个月和 12 个月时的西安大略和麦克马斯特大学骨关节炎指数和非关节炎髋关节评分均有显著改善（P<0.05）。术前和术后 6 个月或 12 个月时，3 组之间的结局评分无显著差异。
同期股骨髋臼撞击症手术不会导致更高的并发症、术后疼痛、镇痛药物使用或副作用发生率。恢复日常活动的时间与单髋手术相似，具有单次康复的优势。
III 级，回顾性比较研究。
