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关节镜下治疗股骨髋臼撞击症的关节囊外入路:临床、影像学结果及并发症

Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications.

作者信息

Roos Bruno Dutra, Roos Milton Valdomiro, Júnior Antero Camisa, Lima Ezequiel Moreno Ungaretti, Gyboski Diego Paulo, Martins Lucas Schirmer

机构信息

Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brazil.

出版信息

Rev Bras Ortop. 2015 Jul 3;50(4):430-7. doi: 10.1016/j.rboe.2015.06.011. eCollection 2015 Jul-Aug.

Abstract

OBJECTIVES

To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach.

METHODS

Between January 2011 and March 2012, 49 patients (50 hips) underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips) fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS), the Non-Arthritic Hip score (NAHS) and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip.

RESULTS

Out of the 41 hips treated, 31 (75.6%) presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4̊ for the internal rotation of the hip (p < 0.001). Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9̊ and mean increase of 0.10, respectively (p < 0.001).

CONCLUSION

Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

摘要

目的

评估采用关节囊外入路对股骨髋臼撞击症患者进行关节镜治疗的临床及影像学结果和并发症。

方法

2011年1月至2012年3月期间,49例(50髋)患者接受了南里奥格兰德州帕索丰杜骨科医院髋关节手术团队进行的股骨髋臼撞击症关节镜治疗。40例(41髋)患者符合本研究的所有要求。平均随访时间为29.1个月。通过经伯德改良的哈里斯髋关节评分(MHHS)、非关节炎髋关节评分(NAHS)以及髋关节内旋对患者进行临床评估。还对其髋关节进行影像学评估,测量CE角、关节间隙尺寸、α角、头颈指数、关节病程度以及髋关节异位骨化情况。

结果

在接受治疗的41髋中,31髋(75.6%)呈现出良好或优秀的临床结果。MHHS术后平均增加22.1分,NAHS增加21.5分,髋关节内旋增加16.4°(p < 0.001)。在影像学评估方面,α角和头颈指数矫正至正常值,术后平均分别下降32.9°和增加0.10(p < 0.001)。

结论

采用关节囊外入路对股骨髋臼撞击症进行关节镜治疗,在平均29.1个月的随访中呈现出令人满意的临床和影像学结果,并发症较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9e2/4563045/44955faf7884/gr1.jpg

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