Bayley Gillian, Poitras Stephane, Parker Gillian, Beaulé Paul E
The Ottawa Hospital, Ottawa, Ontario - Canada.
University of Ottawa, Ottawa, Ontario - Canada.
Hip Int. 2017 Sep 19;27(5):436-442. doi: 10.5301/hipint.5000493. Epub 2017 Jun 7.
Hip arthroscopy has evolved into a well-established and rapidly growing field of orthopedic surgery for the management of labral tears. The purpose of this study was to review clinical outcomes of patients less than 25 years of age undergoing hip arthroscopy for treatment of a labral tear.
From 2005 to 2013, 82 hips in 76 patients with mean age of 20.4 (16-25 range) underwent hip arthroscopy for treatment of labral-chondral damage. The Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and hip disability and osteoarthritis outcome score (HOOS) were recorded at latest follow-up.
36 of 86 hips (42%) had isolated labral pathology with no associated bony pathology (normal alpha and centre-edge angle; no retroversion). Beck score (intraoperative cartilage damage) of 3 or more was significantly associated with an alpha angle of more than 55 degrees (odds ratio [OR], 3.6; confidence interval [CI], 1.2-11.0) and presence of femeroacetabular impingement (OR, 4.5; CI, 1.3-15.2). HOOS pain, sports/recreation, and quality of life significantly improved from preoperative to one year after surgery (p<0.05). 8 patients had re-operations for persistent pain; 5 underwent arthroscopic labral repair; 2 underwent arthroscopy with subsequent periacetabular osteotomy (PAO); 1 had only a periacetabular osteotomy (PAO). Complications included 2 lateral femoral cutaneous nerve deficits and 1 deep vein thrombosis.
Labral tears in patients less than 25 years of age occurs commonly without bony deformities, with those with normal head/neck contour demonstrating significantly less early cartilage damage than those with bony pathology. Hip arthroscopy in young patients can improve function and quality of life with minimal morbidity.
髋关节镜检查已发展成为骨科手术中一个成熟且快速发展的领域，用于治疗盂唇撕裂。本研究的目的是回顾年龄小于25岁的患者接受髋关节镜检查治疗盂唇撕裂的临床结果。
2005年至2013年，76例平均年龄20.4岁（年龄范围16 - 25岁）患者的82个髋关节接受了髋关节镜检查以治疗盂唇软骨损伤。在最近一次随访时记录了西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及髋关节残疾和骨关节炎结果评分（HOOS）。
86个髋关节中的36个（42%）存在孤立的盂唇病变，无相关骨质病变（阿尔法角和中心边缘角正常；无髋臼后倾）。贝克评分（术中软骨损伤）为3分或更高与阿尔法角大于55度（优势比[OR]，3.6；置信区间[CI]，1.2 - 11.0）以及股骨髋臼撞击症的存在（OR，4.5；CI，1.3 - 15.2）显著相关。HOOS疼痛、运动/娱乐和生活质量从术前到术后一年有显著改善（p<0.05）。8例患者因持续疼痛接受了再次手术；5例行关节镜下盂唇修复；2例行关节镜检查并随后进行髋臼周围截骨术（PAO）；1例仅进行了髋臼周围截骨术（PAO）。并发症包括2例股外侧皮神经缺损和1例深静脉血栓形成。
年龄小于25岁的患者发生盂唇撕裂通常无骨质畸形，头部/颈部轮廓正常的患者早期软骨损伤明显少于有骨质病变的患者。年轻患者进行髋关节镜检查可在发病率极低的情况下改善功能和生活质量。
