Niroopan Gavinn, de Sa Darren, MacDonald Austin, Burrow Sarah, Larson Christopher M, Ayeni Olufemi R
Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Center, Hamilton, Ontario, Canada.
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Arthroscopy. 2016 Apr;32(4):692-703.e1. doi: 10.1016/j.arthro.2015.12.029. Epub 2016 Feb 28.
This systematic review explored the indications, efficacy, and complications of hip arthroscopy in the setting of trauma.
Databases (PubMed, Medline, Embase, and Web of Science) were searched from database inception to March 2015 for studies using hip arthroscopy in trauma treatment. Systematic screening of eligible studies was undertaken in duplicate. The inclusion criteria included studies pertaining to arthroscopic intervention of all traumatic hip injuries. Abstracted data were organized in table format with descriptive statistics presented.
From an initial search yield of 2,809 studies, 32 studies (25 case reports and 7 case series) satisfied the criteria for inclusion. A total of 144 patients (age range, 10 to 53 years) underwent hip arthroscopy for 6 indications associated with trauma: 8 patients for bullet extraction, 6 for femoral head fixation, 82 for loose body removal, 6 for acetabular fracture fixation, 20 for labral intervention, and 23 for ligamentum teres debridement. Patients were followed up postoperatively for a mean of 2.9 years (range, 8 days to 16 years). Successful surgery was achieved in 96% of patients. The rate of major complications (i.e., pulmonary embolism and abdominal compartment syndrome) was 1.4% (2 of 144); avascular necrosis, 1.4% (2 of 144); and nerve palsy, 0.7% (1 of 144).
Hip arthroscopy appears effective and safe in the setting of trauma. These data should be interpreted with caution because of the low-quality evidence of the included studies. Surgeons should be aware of the potential complications such as abdominal compartment syndrome and thromboembolic events when performing hip arthroscopy in the setting of trauma.
Level IV, systematic review of Level IV studies.
本系统评价探讨了创伤情况下髋关节镜检查的适应证、疗效及并发症。
检索数据库（PubMed、Medline、Embase和科学网）自建库起至2015年3月间使用髋关节镜治疗创伤的研究。对符合条件的研究进行双人系统筛查。纳入标准包括与所有创伤性髋关节损伤的关节镜干预相关的研究。提取的数据以表格形式整理，并呈现描述性统计结果。
初步检索得到2809项研究，其中32项研究（25例病例报告和7个病例系列）符合纳入标准。共有144例患者（年龄范围10至53岁）因与创伤相关的6种适应证接受了髋关节镜检查：8例用于取出子弹，6例用于股骨头固定，82例用于取出游离体，6例用于髋臼骨折固定，20例用于盂唇干预，23例用于圆韧带清创。患者术后平均随访2.9年（范围8天至16年）。96%的患者手术成功。主要并发症（即肺栓塞和腹腔间隔室综合征）发生率为1.4%（144例中有2例）；缺血性坏死发生率为1.4%（144例中有2例）；神经麻痹发生率为0.7%（144例中有1例）。
在创伤情况下，髋关节镜检查似乎有效且安全。由于纳入研究的证据质量较低，这些数据应谨慎解读。外科医生在创伤情况下进行髋关节镜检查时应意识到潜在并发症，如腹腔间隔室综合征和血栓栓塞事件。
IV级，IV级研究的系统评价。
