School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.
The University of Melbourne, Melbourne, Victoria, Australia.
Br J Sports Med. 2014 Jul;48(14):1102-7. doi: 10.1136/bjsports-2013-093312. Epub 2014 Mar 21.
This study aimed to describe chondropathy prevalence in adults who had undergone hip arthroscopy for hip pain. The relationships between chondropathy severity and (1) participant characteristics; and (2) patient-reported outcomes (PROs) at initial assessment (∼18 months postsurgery) and over a further 12 months (∼30 months postsurgery) were evaluated. Finally, the relationships between chondropathy and coexisting femoroacetabular impingement (FAI) and labral pathology at the time of surgery were evaluated.
100 consecutive patients (36±12 years) who underwent hip arthroscopy 18 months previously participated. Hip Osteoarthritis and Disability Outcome Score (HOOS) and International Hip Outcome Tool (iHOT-33) data were collected prospectively at 18 months postsurgery and at 30 months postsurgery. Surgical data were collected retrospectively. Participants were grouped: Outerbridge grade 0, no chondropathy; Outerbridge grade I-II, mild chondropathy; Outerbridge III-IV, severe chondropathy. The presence of FAI or labral pathology was noted.
The prevalence of chondropathy (≥grade I) at hip arthroscopy was 72%. Participants with severe chondropathy were significantly worse for all HOOS subscales and the iHOT-33 at 18 months postsurgery (HOOS-symptoms (p=0.017); HOOS-pain (p=0.024); HOOS-activity (p=0.009); HOOS-sport (p=0.004); HOOS-quality-of-life (p=0.006); iHOT-33 (p=0.013)) than those with no chondropathy. At 12-month follow-up, HOOS-quality-of-life in those without chondropathy was the only PRO that improved. Relative risk of coexisting chondropathy with labral pathology or FAI was 40%.
Chondropathy was prevalent, and associated with increasing age, coexisting labral pathology or FAI. Severe chondropathy was associated with worse pain and function at 18 months postsurgery. Little improvements were observed in participants over a further 12 months, regardless of chondropathy status.
本研究旨在描述髋关节疼痛接受髋关节镜检查的成年人中软骨病的患病率。评估软骨病严重程度与（1）参与者特征；以及（2）初始评估时（≈18 个月术后）和进一步 12 个月（≈30 个月术后）的患者报告结果（PROs）之间的关系。最后，评估软骨病与同时存在的股骨髋臼撞击症（FAI）和手术时的盂唇病理之间的关系。
100 例连续患者（36±12 岁），在 18 个月前接受髋关节镜检查，术后 18 个月和 30 个月前瞻性收集髋关节骨关节炎和残疾结果评分（HOOS）和国际髋关节结果工具（iHOT-33）数据。回顾性收集手术数据。参与者分为：Outerbridge 0 级，无软骨病；Outerbridge I-II 级，轻度软骨病；Outerbridge III-IV 级，严重软骨病。注意到 FAI 或盂唇病理的存在。
髋关节镜检查软骨病（≥grade I）的患病率为 72%。在术后 18 个月时，严重软骨病患者在所有 HOOS 子量表和 iHOT-33 方面的得分均明显较差（HOOS-症状（p=0.017）；HOOS-疼痛（p=0.024）；HOOS-活动度（p=0.009）；HOOS-运动（p=0.004）；HOOS-生活质量（p=0.006）；iHOT-33（p=0.013））比没有软骨病的患者差。在 12 个月的随访中，没有软骨病的患者的 HOOS 生活质量是唯一改善的 PRO。伴有盂唇病理或 FAI 的同时存在软骨病的相对风险为 40%。
软骨病很常见，与年龄增长、同时存在的盂唇病理或 FAI 有关。严重的软骨病与术后 18 个月时的疼痛和功能更差有关。无论软骨病状况如何，在进一步的 12 个月中，参与者的改善都很少。
