Degen Ryan M, Nawabi Danyal H, Fields Kara G, Wentzel C Sally, Kelly Bryan T, Coleman Struan H
Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A..
Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
Arthroscopy. 2016 Jul;32(7):1300-7. doi: 10.1016/j.arthro.2016.01.047. Epub 2016 Apr 27.
To compare the clinical outcomes and complication rates of patients undergoing simultaneous versus staged bilateral hip arthroscopy for bilateral symptomatic femoroacetabular impingement (FAI).
Between 2010 and 2013, a total of 1,800 hip arthroscopy cases were retrospectively reviewed for cases of simultaneous bilateral hip arthroscopy. All patients with minimum 1-year follow-up were included. This group was matched 1:2 for age, sex, and alpha angle, to a control group of patients who underwent staged, bilateral procedures. Patient-reported outcome scores, including the Modified Harris Hip Score (mHHS), the Hip Outcome Score-Activity of Daily Living (HOS-ADL), and the Hip Outcome Score-Sport-Specific Subscale (HOS-SSS) were obtained preoperatively at 6 months and 1 and 2 years postoperatively.
Eighty-one patients (162 hips) were identified who underwent bilateral hip arthroscopy for symptomatic FAI. Twelve patients (24 hips) who underwent simultaneous bilateral arthroscopy with minimum 1-year follow-up were compared with a matched cohort of 24 patients (48 hips) who underwent staged bilateral procedures. Mean preoperative alpha angle was 65.3° ± 9.6° in the simultaneous group and 65.9° ± 11.2° in the staged group (P = .6). At a mean follow-up of 17.8 months (range, 12 to 33 months), there were comparable improvements in simultaneous versus staged patient-reported outcome scores (mHHS 90.8 ± 11 v 88.9 ± 12.5, P = .662; HOS-ADL 97.3 ± 3.8 v 92.6 ± 10.3, P = .057; HOS-SSS 93.3 ± 10.2 v 86.5 ± 16.6, P = .203). The mean single anesthetic traction time was 90.8 ± 21.9 minutes (sum of both hips) in the simultaneous group, compared with a combined 2-anesthetic traction time of 85.7 ± 27.2 minutes in the staged group (P = .579). There were no traction-related complications in either group. No patients in the simultaneous group required revision surgery, whereas 1 patient in the staged group required lysis of adhesions at 24 months postoperatively.
In a small sample, simultaneous bilateral hip arthroscopy is shown to be safe and effective, resulting in similar improvements in patient-reported outcomes at 1-year follow-up compared with staged bilateral procedures.
Level III, case-control study.
比较同期双侧髋关节镜手术与分期双侧髋关节镜手术治疗双侧有症状的股骨髋臼撞击症（FAI）患者的临床疗效和并发症发生率。
回顾性分析2010年至2013年间1800例髋关节镜手术病例中的同期双侧髋关节镜手术病例。纳入所有至少随访1年的患者。该组患者按年龄、性别和α角1:2匹配至接受分期双侧手术的对照组患者。术前、术后6个月、1年和2年获取患者报告的结局评分，包括改良Harris髋关节评分（mHHS）、髋关节结局评分-日常生活活动（HOS-ADL）和髋关节结局评分-运动特定子量表（HOS-SSS）。
共识别出81例（162髋）因有症状的FAI接受双侧髋关节镜手术的患者。将12例（24髋）接受同期双侧关节镜手术且至少随访1年的患者与24例（48髋）接受分期双侧手术的匹配队列进行比较。同期组术前平均α角为65.3°±9.6°，分期组为65.9°±11.2°（P = 0.6）。平均随访17.8个月（范围12至33个月）时，同期与分期患者报告的结局评分有相似改善（mHHS 90.8±11对88.9±12.5，P = 0.662；HOS-ADL 97.3±3.8对92.6±10.3，P = 0.057；HOS-SSS 93.3±10.2对86.5±16.6，P = 0.203）。同期组平均单次麻醉牵引时间为90.8±21.9分钟（双侧总和），分期组两次麻醉牵引时间总和为85.7±27.2分钟（P = 0.579）。两组均无牵引相关并发症。同期组无患者需要翻修手术，而分期组有1例患者在术后24个月需要粘连松解。
在小样本中，同期双侧髋关节镜手术显示安全有效，与分期双侧手术相比，1年随访时患者报告的结局有相似改善。
III级，病例对照研究。
