Rath Ehud, Sharfman Zachary T, Paret Matan, Amar Eyal, Drexler Michael, Bonin Nicolas
Department of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine,Tel Aviv University, Tel Aviv, Israel.
Lyon Ortho Clinic, Clinique de la sauvegarde, 25 B avenue des sources, Lyon 69009, France.
J Hip Preserv Surg. 2017 Feb 23;4(1):60-66. doi: 10.1093/jhps/hnw045. eCollection 2017 Jan.
The objectives of this study are to survey the weight-bearing limitation practices and delay for returning to running and impact sports of high volume hip arthroscopy orthopedic surgeons. The study was designed in the form of expert survey questionnaire. Evidence-based data are scares regarding hip arthroscopy post-operative weight-bearing protocols. An international cross-sectional anonymous Internet survey of 26 high-volume hip arthroscopy specialized surgeons was conducted to report their weight-bearing limitations and rehabilitation protocols after various arthroscopic hip procedures. The International Society of Hip Arthroscopy invited this study. The results were examined in the context of supporting literature to inform the studies suggestions. Four surgeons always allow immediate weight bearing and five never offer immediate weight bearing. Seventeen surgeons provide weight bearing depending on the procedures performed: 17 surgeons allowed immediate weight bearing after labral resection, 10 after labral repair and 8 after labral reconstruction. Sixteen surgeons allow immediate weight bearing after psoas tenotomy. Twenty-one respondents restrict weight bearing after microfracture procedures for 3-8 weeks post-operatively. Return to running and impact sports were shorter for labral procedures and bony procedures and longer for cartilaginous and capsular procedures. Marked variability exists in the post-operative weight-bearing practices of hip arthroscopy surgeons. This study suggests that most surgeons allow immediate weight bearing as tolerated after labral resection, acetabular osteoplasty, chondroplasty and psoas tenotomy. For cartilage defect procedures, 6 weeks or more non-weight bearing is suggested depending on the area of the defect and lateral central edge angle. Delayed return to sports activities is suggested after microfracture procedures. The level of evidence was Level V expert opinions.
本研究的目的是调查大量开展髋关节镜手术的骨科医生在负重限制做法以及恢复跑步和冲击性运动方面的延迟情况。该研究采用专家调查问卷的形式设计。关于髋关节镜手术后负重方案的循证数据匮乏。对26位大量开展髋关节镜手术的专科医生进行了一项国际横断面匿名网络调查，以报告他们在各种关节镜髋关节手术后的负重限制和康复方案。国际髋关节镜学会邀请开展了这项研究。结合支持性文献对结果进行了审视，以为研究建议提供参考。4位医生始终允许立即负重，5位医生从不允许立即负重。17位医生根据所实施的手术来决定是否允许负重：17位医生在唇状软骨切除术之后允许立即负重，10位在唇状软骨修复术后允许，8位在唇状软骨重建术后允许。16位医生在腰大肌切断术后允许立即负重。21位受访者在微骨折手术后限制负重3至8周。对于唇状软骨手术和骨性手术，恢复跑步和冲击性运动的时间较短，而对于软骨和关节囊手术则较长。髋关节镜手术医生术后的负重做法存在显著差异。本研究表明，大多数医生在唇状软骨切除术、髋臼截骨术、软骨成形术和腰大肌切断术后允许根据耐受情况立即负重。对于软骨缺损手术，根据缺损面积和外侧中央边缘角，建议6周或更长时间不负重。微骨折手术后建议推迟恢复体育活动。证据级别为V级专家意见。
