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30岁以上患者股骨髋臼撞击症的开放手术治疗:两年随访结果

Open Surgical Treatment for Femoroacetabular Impingement in Patients over Thirty Years: Two Years Follow-up Results.

作者信息

Cho Su-Hyun

机构信息

Department of Orthopaedic Surgery, Changwon Hospital, Changwon, Korea.

出版信息

Hip Pelvis. 2015 Dec;27(4):241-9. doi: 10.5371/hp.2015.27.4.241. Epub 2015 Dec 30.

Abstract

PURPOSE

We report short term results of open surgical treatment for symptomatic femoroacetabular impingement (FAI) in patients over the age of 30 years.

MATERIALS AND METHODS

Between May 2011 and June 2012, thirteen FAI hips (11 patients) with hip pain persisting longer than 6 months were treated by either surgical hip dislocation (SHD) or anterior mini-open. They were followed up for longer than 2 years. The 11 patients included 7 females and 4 males with a mean age of 45 (range, 33-60) years. They were clinically evaluated for modified Harris hip score (MHHS) and University of California at Los Angeles (UCLA) activity level. Their lateral center-edge angle, acetabular index, and alpha angle were measured and compared.

RESULTS

Acetabuloplasties were performed for seven cases. Femoral osteochondroplasty was performed for all thirteen cases. At minimum follow-up of two year (range, 24-29 months), all patients had substantial relief in preoperative pain with improvement in range of motion. The median MHHS was significantly (P<0.05) improved from 61 points preoperatively to 87 points at the last follow-up. The median UCLA activity level was 7 (range, 5-8) at last follow-up. Radiological indices improved. Two cases showed mild residual pain attributable to adhesion between capsule and reshaped femoral head-neck area.

CONCLUSION

Open surgical treatment of FAI was a reliable and effective treatment method in symptomatic FAIs for patients over the age of 30 years without advanced arthritic change of hip joint at short term follow-up.

摘要

目的

我们报告了30岁以上有症状的股骨髋臼撞击症(FAI)患者开放手术治疗的短期结果。

材料与方法

2011年5月至2012年6月期间,对13例(11名患者)髋部疼痛持续超过6个月的FAI髋关节采用手术性髋关节脱位(SHD)或前方小切口开放手术进行治疗。对他们进行了超过2年的随访。11名患者包括7名女性和4名男性,平均年龄为45岁(范围33 - 60岁)。对他们进行了改良Harris髋关节评分(MHHS)和加州大学洛杉矶分校(UCLA)活动水平的临床评估。测量并比较了他们的外侧中心边缘角、髋臼指数和α角。

结果

7例患者进行了髋臼成形术。13例患者均进行了股骨骨软骨成形术。在至少两年(范围24 - 29个月)的随访中,所有患者术前疼痛均得到显著缓解,活动范围有所改善。MHHS中位数从术前的61分显著(P<0.05)提高到最后一次随访时的87分。最后一次随访时UCLA活动水平中位数为7(范围5 - 8)。影像学指标有所改善。2例患者表现出轻度残留疼痛,归因于关节囊与重塑的股骨头 - 颈区域之间的粘连。

结论

对于30岁以上、短期内无髋关节晚期关节炎改变的有症状FAI患者,开放手术治疗FAI是一种可靠且有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c2b/4972795/70a281e54851/hp-27-241-g001.jpg

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