Capogna Brian M, Ryan Michael K, Begly John P, Chenard Kristofer E, Mahure Siddharth A, Youm Thomas
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, U.S.A.
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York, U.S.A..
Arthroscopy. 2016 Dec;32(12):2505-2510. doi: 10.1016/j.arthro.2016.06.026. Epub 2016 Aug 17.
To examine clinical outcomes and survivorship in patients aged 60 years or older who underwent hip arthroscopy for management of hip pain.
Prospectively collected data for patients 60 or older undergoing hip arthroscopy were obtained. All patients were indicated for hip arthroscopy based on standard preoperative examination as well as routine and advanced imaging. Demographic data, diagnosis, and details regarding operative procedures were collected. Baseline preoperative modified Harris Hip Scores (mHHS) and Non-arthritic Hip Scores (NAHS) were compared to mHHS and NAHS at the 2-year follow-up. Survivorship was assessed to determine failure rates, with failure defined as any subsequent ipsilateral revision arthroscopic surgery and/or hip arthroplasty.
Forty-two patients met inclusion criteria. Mean age (standard deviation) and body mass index were 65.8 years (4.5 years) and 26.1 (4.7), respectively. Baseline mean mHHS and NAHS for all patients improved from 47.8 (±12.5) and 47.3 (±13.6) to 75.6 (±17.6) and 78.3 (±18.6), respectively (P < .001 for both). Five patients (11.9%) met failure criteria and underwent additional surgery at an average of 14.8 (8-30) months. Three underwent conversion to total hip arthroplasty (7.1%), whereas 2 had revision arthroscopy with cam/pincer resection and labral repair for recurrent symptoms (4.7%). One- and 2-year survival rates were 95.2% and 88.9%, respectively.
Our results suggest that in patients 60 or older with Tonnis grade 0 or 1 osteoarthritic changes on initial radiographs-treatment with hip arthroscopy can lead to reliable improvement in early outcomes. As use of hip arthroscopy for treatment of mechanical hip pain increases, additional studies with long-term follow-up are needed.
Level IV, therapeutic case series.
研究60岁及以上因髋关节疼痛接受髋关节镜手术患者的临床结局和生存率。
获取前瞻性收集的60岁及以上接受髋关节镜手术患者的数据。所有患者均根据标准术前检查以及常规和高级影像学检查结果被确定适合进行髋关节镜手术。收集人口统计学数据、诊断结果以及手术操作细节。将术前基线改良Harris髋关节评分（mHHS）和非关节炎髋关节评分（NAHS）与2年随访时的mHHS和NAHS进行比较。评估生存率以确定失败率，失败定义为随后进行的同侧翻修关节镜手术和/或髋关节置换术。
42例患者符合纳入标准。平均年龄（标准差）和体重指数分别为65.8岁（4.5岁）和26.1（4.7）。所有患者的基线平均mHHS和NAHS分别从47.8（±12.5）和47.3（±13.6）提高到75.6（±17.6）和78.3（±18.6）（两者P均<0.001）。5例患者（11.9%）符合失败标准并平均在14.8（8 - 30）个月时接受了额外手术。3例患者接受了全髋关节置换术（7.1%），而2例患者因复发症状接受了翻修关节镜手术，包括凸轮/钳夹切除和盂唇修复（4.7%）。1年和2年生存率分别为95.2%和88.9%。
我们的结果表明，对于初始X线片显示Tonnis分级为0或1级骨关节炎改变的60岁及以上患者，髋关节镜治疗可使早期结局得到可靠改善。随着髋关节镜用于治疗机械性髋关节疼痛的应用增加，需要进行更多长期随访研究。
IV级，治疗性病例系列。
