Byrd J W Thomas, Jones Kay S, Freeman Carl R
Nashville Sports Medicine Foundation, Nashville, Tennessee, U.S.A.
Nashville Sports Medicine Foundation, Nashville, Tennessee, U.S.A..
Arthroscopy. 2016 Jun;32(6):1022-9. doi: 10.1016/j.arthro.2015.12.042. Epub 2016 Mar 9.
To describe the clinical findings associated with labral ossification (LO), report the outcomes of arthroscopic treatment, and compare this condition to a control group with femoroacetabular impingement (FAI).
A retrospective review of hip arthroscopy patients from 2004 to 2013 was performed to identify patients with a diagnosis of pincer FAI with LO and at least 2 years of follow-up. Diagnosis was made by plain radiograph, computed tomography, magnetic resonance imaging, or intraoperatively. The LO cohort was compared to a chronologically matched control group of FAI patients with pincer FAI but no LO. Patients were prospectively assessed with modified Harris Hip Score (mHHS) preoperatively and then postoperatively at 3, 12, 24, 60, and 120 months.
The LO group included 56 hips in 52 patients whereas the control group included 56 hips in 56 patients. Mean follow-up was 36 months for the LO group and 38 for the control group (P = .28). Patients in the LO group were older than those in the control group, with a mean age of 45 versus 30 years (P < .0001), and had more women: 58% female versus 32% male (P < .0001). The LO group patients were more likely to have pain while sitting (65% v 18%) and restricted activities of daily living (40% v 11%) than the control group (P < .0001), and more likely to have pain during a flexion, abduction, external rotation (FABER) test (67% v 36%) (P = .002). Both groups experienced a similar magnitude of improvement in mHHS, but the LO group had a significantly lower preoperative mHHS (49 v 63, P < .001) and final postoperative mHHS (75 v 87, P < .0001) than the control group.
Patients with LO represent a unique subset of pincer FAI and are more likely to be older, female, and have more severe symptoms. Hip arthroscopy can be used to treat LO with excision of the ossified fragments or rim, with a reasonable expectation of improvement of symptoms.
III, retrospective case-control.
描述与髋臼盂唇骨化（LO）相关的临床发现，报告关节镜治疗的结果，并将这种情况与伴有股骨髋臼撞击症（FAI）的对照组进行比较。
对2004年至2013年接受髋关节镜检查的患者进行回顾性研究，以确定诊断为钳夹型FAI合并LO且至少随访2年的患者。通过X线平片、计算机断层扫描、磁共振成像或术中诊断。将LO队列与按时间顺序匹配的钳夹型FAI但无LO的FAI患者对照组进行比较。术前和术后3、12、24、60和120个月对患者进行前瞻性改良Harris髋关节评分（mHHS）评估。
LO组包括52例患者的56个髋关节，而对照组包括56例患者的56个髋关节。LO组的平均随访时间为36个月，对照组为38个月（P = 0.28）。LO组患者比对照组年龄更大，平均年龄分别为45岁和30岁（P < 0.0001），女性更多：女性占58%，男性占32%（P < 0.0001）。与对照组相比，LO组患者在坐位时更易出现疼痛（65%对18%）和日常生活活动受限（40%对11%）（P < 0.0001），在屈曲、外展、外旋（FABER）试验时更易出现疼痛（67%对36%）（P = 0.002）。两组mHHS改善程度相似，但LO组术前mHHS（49对63，P < 0.001）和术后最终mHHS（75对87，P < 0.0001）均显著低于对照组。
LO患者是钳夹型FAI的一个独特亚组，更可能年龄较大、为女性且症状更严重。髋关节镜可用于通过切除骨化碎片或髋臼边缘来治疗LO，有望合理改善症状。
III，回顾性病例对照研究。
