Mardones Rodrigo, Via Alessio Giai, Rivera Alvaro, Tomic Alexander, Somarriva Marcelo, Wainer Mauricio, Camacho Daniel
Department of Adult Reconstruction Surgery Hip/Knee and Hip Arthroscopy, Clínica Las Condes, Santiago de Chile, Chile.
Muscles Ligaments Tendons J. 2016 Dec 21;6(3):397-401. doi: 10.11138/mltj/2016.6.3.397. eCollection 2016 Jul-Sep.
The indications of hip arthroscopy increased over the past decade. Although mostly recommended for treatment of femoroacetabular impingement (FAI) in young patients, well-selected older patients (> 60 years old) may benefit from this surgery. However, the role of hip arthroscopy for the management of older patients is controversial. The aim of the study is to evaluate the clinical outcomes of a series of patients aged 60 years and older who underwent hip arthroscopy for FAI at mid-term follow-up.
Sixty-year-old patients and older, with a joint space greater than 2 mm, and a grade I and II hip osteoarthrosis (OA) according Tönnis scale were included into the study. Twenty-three patients (28 hips) met the inclusion criteria. The T-Student test was used to detect for differences between variables (p<0.05).
The mean age of the patients was 63.4 years, and the mean follow-up was 4.4 years (2-9 years). We found an improvement in mHHS and VAS score from the baseline to the final follow-up in 87% of patients (p<0.05). Three patients (13%) were submitted to a THA at a mean of 12 months, while the survivorship rate at the final follow-up was 75%. No major complications have been reported.
Arthroscopic treatment of FAI in patients over 60 years old, with no signs of advanced osteoarthrosis, showed a significant improvement of functional score and pain in most of cases, and it can be consider a reasonable option in well selected patients. Level of evidence: IV case series.
在过去十年中,髋关节镜检查的适应症有所增加。虽然大多推荐用于治疗年轻患者的股骨髋臼撞击症(FAI),但精心挑选的老年患者(>60岁)可能从该手术中获益。然而,髋关节镜检查在老年患者管理中的作用存在争议。本研究的目的是评估一系列60岁及以上因FAI接受髋关节镜检查的患者在中期随访时的临床结果。
纳入年龄60岁及以上、关节间隙大于2mm且根据Tönnis分级为I级和II级髋关节骨关节炎(OA)的患者。23例患者(28髋)符合纳入标准。采用t检验检测变量间差异(p<0.05)。
患者的平均年龄为63.4岁,平均随访时间为4.4年(2 - 9年)。我们发现87%的患者从基线到最终随访时mHHS和VAS评分有所改善(p<0.05)。3例患者(13%)平均在12个月时接受了全髋关节置换术(THA),而最终随访时的生存率为75%。未报告重大并发症。
对60岁以上无晚期骨关节炎迹象的患者进行关节镜下FAI治疗,在大多数情况下功能评分和疼痛有显著改善,对于精心挑选的患者可认为是一种合理的选择。证据水平:IV级病例系列。