Nabavi Arash, Olwill Caroline M, Harris Ian A
The Sydney Bone and Joint Clinic, Sydney - Australia.
Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney - Australia.
Hip Int. 2015 Sep-Oct;25(5):402-5. doi: 10.5301/hipint.5000261. Epub 2015 May 27.
The aim of this study was to establish preoperative factors associated with a good outcome in the surgical treatment of femoroacetabular impingement.
A prospective study including 253 consecutive patients (280 hips) was carried out. We defined a "good" score as one which had either a 20 point improvement from preoperative to 12 months postoperative follow-up, or a score of over 80 points at 12-month follow-up in either the Non Arthritic Hip Score (NAHS) or Modified Harris Hip Score (MHHS). We analysed 9 potential predictors of 12-month postoperative outcome: patient age, gender, BMI, surgery type (primary/revision), preoperative anxiety level, preoperative labro-chondral damage, operative side, patients belonging to the armed forces and patients being treated under the workers compensation scheme. We used logistic regression (multivariable, adjusted) and, Fisher's exact test and student t test (bivariate, unadjusted) to analyse the data.
A strong association between workers' compensation status and not achieving a good outcome following arthroscopic surgery for femoroacetabular impingement (odds ratio 3.84, 95% CI, 0.13-0.51, P<0.0001) was found. A negative effect on postoperative outcome was also observed with increased BMI, although this association was modest (odds ratio 1.06, 95% CI, 0.87-0.99 p = 0.03). Patients with a higher preoperative score did better at 12 months than the rest of the cohort.
The data from this study may be useful for both patient and physician to consider when deciding on a suitable treatment in potential surgical candidates suffering from femoroacetabular impingement.
本研究旨在确定与股骨髋臼撞击症手术治疗良好预后相关的术前因素。
开展了一项前瞻性研究，纳入253例连续患者（280髋）。我们将“良好”评分定义为术前至术后12个月随访时提高20分，或在非关节炎髋关节评分（NAHS）或改良Harris髋关节评分（MHHS）的12个月随访时得分超过80分。我们分析了术后12个月结果的9个潜在预测因素：患者年龄、性别、体重指数、手术类型（初次/翻修）、术前焦虑水平、术前盂唇软骨损伤、手术侧、军人患者以及根据工伤赔偿计划接受治疗的患者。我们使用逻辑回归（多变量，校正）以及Fisher精确检验和学生t检验（双变量，未校正）来分析数据。
发现工伤赔偿状态与股骨髋臼撞击症关节镜手术后未取得良好预后之间存在密切关联（比值比3.84，95%可信区间，0.13 - 0.51，P<0.0001）。体重指数增加对术后结果也有负面影响，尽管这种关联较弱（比值比1.06，95%可信区间，0.87 - 0.99，P = 0.03）。术前评分较高的患者在12个月时的表现优于队列中的其他患者。
本研究的数据可能有助于患者和医生在为患有股骨髋臼撞击症的潜在手术候选人决定合适的治疗方案时进行考虑。
