Lund Bent, Nielsen Torsten Grønbech, Lind Martin
Department of Orthopaedics, Horsens Regional Hospital, 8700 Horsens, Denmark.
Department of Orthopaedics, Aarhus University Hospital THG, 8000 Aarhus C, Denmark.
SICOT J. 2017;3:44. doi: 10.1051/sicotj/2017023. Epub 2017 Jun 14.
The femoroacetabular impingement (FAI) morphology is associated with specific cartilage lesions, which are suspected to be early stages of the osteoarthritic development, which can be the end result of FAI. The cartilage status of FAI afflicted hip joints at the time of arthroscopic management is not fully elucidated. This study from the Danish Hip Arthroscopy Registry (DHAR) will try to show data on the cartilage status from a large cohort. Data from a national registry potentially represent large amounts of population-based epidemiological information from multiple centres and surgeons. Therefore, outcome data might be more reliable for a specific surgical intervention.
This study includes patients operated for symptomatic FAI from January 2012 until December 31st 2013, with a minimum of two-year follow-up and being registered in DHAR. The extent of cartilage damage at the time of surgery is reported and the Patient Related Outcome Measures (PROM) outcome data are presented.
Data from a total of 686 FAI procedures in 1082 patients from January 2012 until December 31st 2013 were extracted from DHAR. Cartilage injuries were found in 88% of cases, mainly on the acetabular side. Overall PROM including pain scores improved significantly from preoperative status to follow-up one and two years postoperatively. The Copenhagen Hip and Groin Outcome Score (HAGOS), Hip Sports Activity Scale (HSAS) and global hip function showed less improvements in patients with more severe acetabular cartilage injury.
The majority of patients with femoroacetabular impingement (FAI) undergoing hip arthroscopy have significant cartilage changes at the time of surgery primarily at the acetabulum and to a lesser degree at the femoral head. During FAI surgery the majority of patients have cartilage debridement performed but rarely cartilage repair. The presence of severe cartilage injury at the time of arthroscopic FAI surgery results in reduced subjective outcome and hip function.
股骨髋臼撞击症（FAI）的形态与特定的软骨损伤相关，这些损伤被怀疑是骨关节炎发展的早期阶段，而骨关节炎可能是FAI的最终结果。关节镜治疗时FAI患髋关节的软骨状态尚未完全阐明。这项来自丹麦髋关节镜注册中心（DHAR）的研究将试图展示来自大量队列的软骨状态数据。来自国家注册中心的数据可能代表了来自多个中心和外科医生的大量基于人群的流行病学信息。因此，特定手术干预的结果数据可能更可靠。
本研究纳入2012年1月至2013年12月31日因症状性FAI接受手术、至少随访两年并在DHAR注册的患者。报告手术时软骨损伤的程度，并呈现患者相关结局测量（PROM）的结果数据。
从DHAR中提取了2012年1月至2013年12月31日1082例患者中总共686例FAI手术的数据。88%的病例发现有软骨损伤，主要在髋臼侧。包括疼痛评分在内的总体PROM从术前状态到术后一年和两年随访时有显著改善。哥本哈根髋关节和腹股沟结局评分（HAGOS）、髋关节运动活动量表（HSAS）和整体髋关节功能在髋臼软骨损伤较严重的患者中改善较少。
大多数接受髋关节镜检查的股骨髋臼撞击症（FAI）患者在手术时主要在髋臼处有明显的软骨变化，在股骨头处程度较轻。在FAI手术期间，大多数患者进行了软骨清创，但很少进行软骨修复。关节镜下FAI手术时存在严重软骨损伤会导致主观结局和髋关节功能降低。
