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50岁以上患者关节镜手术的临床结果——作为一种关节保留手术,其可行性如何?

Clinical results of arthroscopic surgery in patients over 50 years of age-what viability does it have as a joint preservative surgery?

作者信息

Moriya Mitsutoshi, Fukushima Kensuke, Uchiyama Katsufumi, Takahira Naonobu, Yamamoto Takeaki, Minegishi Yojiro, Takaso Masashi

机构信息

Department of Orthopaedic Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan.

Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.

出版信息

J Orthop Surg Res. 2017 Jan 6;12(1):2. doi: 10.1186/s13018-016-0504-9.

Abstract

BACKGROUND

To identify whether hip arthroscopy is a suitable option for treating hip pain in elderly patients and investigate the clinical outcomes of hip arthroscopic surgery for labrum tear and/or osteoarthritis in patients over 50 years of age.

METHODS

Between August 2009 and May 2014, a series of 23 patients (6 men and 17 women) with a mean age of 59 years underwent arthroscopy. We retrospectively examined the clinical records, radiographs, and outcome questionnaires from all patients. The mean follow-up period was 28 months.

RESULTS

The mean Japan Orthopedic Association hip score after surgery improved by a statistically significant amount. Eight patients (34.8%) were noted to have a progression of osteoarthritis (OA) diagnosed by radiograph, and one underwent THA after 13 months following arthroscopic surgery. The patients in which OA progression was noted were identified as having radiographical OA preoperatively and acetabular cartilage damage in the arthroscopic findings.

CONCLUSIONS

Arthroscopic surgery performed in selected patients over 50 years of age might be beneficial if classified as Tönnis grade 0 preoperatively and/or classified as Outerbridge grade II in the arthroscopic findings.

摘要

背景

确定髋关节镜检查是否是治疗老年患者髋关节疼痛的合适选择,并调查50岁以上患者因盂唇撕裂和/或骨关节炎接受髋关节镜手术的临床结果。

方法

2009年8月至2014年5月,对一系列平均年龄59岁的23例患者(6例男性和17例女性)进行了关节镜检查。我们回顾性检查了所有患者的临床记录、X线片和结果问卷。平均随访期为28个月。

结果

术后日本骨科协会髋关节平均评分有统计学意义的改善。8例患者(34.8%)经X线片诊断为骨关节炎(OA)进展,1例在关节镜手术后13个月接受了全髋关节置换术(THA)。发现OA进展的患者术前被确定为有影像学OA,关节镜检查发现髋臼软骨损伤。

结论

对于50岁以上的选定患者,如果术前分类为Tönnis 0级和/或关节镜检查结果分类为Outerbridge II级,进行关节镜手术可能有益。

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