Más Martínez J, Sanz-Reig J, Verdú Román C M, Bustamante Suárez de Puga D, Morales Santías M, Martínez Giménez E
Traumatología Vistahermosa, Clínica Vistahermosa, Alicante, España.
Traumatología Vistahermosa, Clínica Vistahermosa, Alicante, España.
Rev Esp Cir Ortop Traumatol. 2017 May-Jun;61(3):154-161. doi: 10.1016/j.recot.2016.11.004. Epub 2017 Feb 22.
Articular cartilage lesions have a direct effect on the success of surgical treatment. The aim of this study was to determine the prevalence rate, location, grade, and factors associated with acetabular rim articular cartilage lesions in patients undergoing hip arthroscopy.
A prospective study was conducted by analysing the intraoperative data of 152 hips in 122 patients treated with hip arthroscopy for femoroacetabular impingement from January 2011 to May 2016. The prevalence rate, location, and grade were calculated, as well as the pre-operative factors associated with acetabular rim articular cartilage lesions.
The mean age of the patients was 38.6 years. The Tönnis grade was 0 in 103 hips, and 1 in 52 hips. Acetabular rim articular cartilage lesions were present in 109 (70.3%) hips. The location of the lesions was superior-anterior. Independent risk factors for the presence of acetabular rim articular cartilage lesions were an alpha-angle equal or greater than 55°, duration of symptoms equal or greater than 20 months, and Tegner activity scale level equal or greater than 6.
Although patients were classified as Tönnis grade 0 and 1, and 3tesla MRI reported acetabular lesions in 1.3% of cases, there was a high frequency of acetabular rim cartilage lesions. Knowledge of the independent risk factors associated with acetabular rim articular cartilage lesions may assist the orthopaedic surgeon with the decision to perform hip arthroscopy.
关节软骨损伤对手术治疗的成功有着直接影响。本研究的目的是确定接受髋关节镜检查患者髋臼边缘关节软骨损伤的患病率、位置、分级以及相关因素。
通过分析2011年1月至2016年5月间122例因股骨髋臼撞击症接受髋关节镜治疗的患者的152个髋关节的术中数据,进行了一项前瞻性研究。计算了患病率、位置和分级,以及与髋臼边缘关节软骨损伤相关的术前因素。
患者的平均年龄为38.6岁。103个髋关节的Tönnis分级为0级,52个髋关节为1级。109个(70.3%)髋关节存在髋臼边缘关节软骨损伤。损伤位置为上前部。髋臼边缘关节软骨损伤存在的独立危险因素为α角等于或大于55°、症状持续时间等于或大于20个月以及Tegner活动量表水平等于或大于6。
尽管患者被分类为Tönnis 0级和1级,且3特斯拉MRI报告髋臼损伤的病例占1.3%,但髋臼边缘软骨损伤的发生率较高。了解与髋臼边缘关节软骨损伤相关的独立危险因素可能有助于骨科医生决定是否进行髋关节镜检查。