Redmond John M, Keegan Molly A, Gupta Asheesh, Worsham Jacob R, Hammarstedt Jon E, Domb Benjamin G
Southeast Orthopedic Specialists, 6500 Bowden Road, Suite 103, Jacksonville, FL 32216, USA.
Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
J Hip Preserv Surg. 2017 Apr 12;4(2):164-169. doi: 10.1093/jhps/hnx010. eCollection 2017 Jul.
This study reviewed pain and outcome scores of patients undergoing revision surgery with heterotopic ossification (HO) excision following previous hip arthroscopy. The aim was to determine if performing the excision arthroscopically improved clinical outcomes. Data were prospectively collected and retrospectively reviewed in patients who had HO removed arthroscopically between February 2008 and 2014. Four patient-reported outcome (PRO) measures were collected: Modified Harris Hip Score (mHHS), Non-Arthritis Hip Score (NAHS), Hip Outcome Score-Activity of Daily Living (HOS-ADL) and Sport-Specific (HOS-SS) subscales. Minimum 1.5 year follow-up from index procedure was available for 23 patients (mean age = 38.6 years). Of the 23 patients who had revision surgery and HO removal, 19 (83%) were available for follow-up. Prior to revision, the average mHHS was 53.4, HOS-ADL 51.4, HOS-SS 24.5, NAHS 50.3 and VAS 6.7. Following revision with HO excision, each score had improved with an average mHHS of 73.62, HOS-ADL of 68.88, HOS SS of 58.51, NAHS of 70.83 and VAS of 4.33. Overall, mHHS increased by 20.26 points ( < 0.001), HOS-ADL increased by 17.48 points ( = 0.023), HOS-SS increased by 34.03 points ( < 0.001), NAHS increased by 20.55 points ( = 0.001) and VAS decreased by 2.38 points ( < 0.001). Patients undergoing revision hip surgery with HO excision demonstrated improved outcome scores and pain resolution; however, few patients achieved a good or excellent result. Revision hip surgery with HO excision should be approached cautiously because of the modest results in this patient group.
本研究回顾了既往髋关节镜检查后行异位骨化(HO)切除翻修手术患者的疼痛及预后评分。目的是确定关节镜下切除是否能改善临床预后。对2008年2月至2014年间接受关节镜下HO切除的患者进行前瞻性数据收集及回顾性分析。收集了四项患者报告结局(PRO)指标:改良Harris髋关节评分(mHHS)、非关节炎髋关节评分(NAHS)、髋关节结局评分-日常生活活动(HOS-ADL)及特定运动(HOS-SS)子量表。23例患者(平均年龄=38.6岁)可获得自索引手术起至少1.5年的随访。在23例行翻修手术及HO切除的患者中,19例(83%)可进行随访。翻修术前,平均mHHS为53.4,HOS-ADL为51.4,HOS-SS为24.5,NAHS为50.3,视觉模拟评分(VAS)为6.7。HO切除翻修术后,各项评分均有所改善,平均mHHS为73.62,HOS-ADL为68.88,HOS-SS为58.51,NAHS为70.83,VAS为4.33。总体而言,mHHS增加了20.26分(<0.001),HOS-ADL增加了17.48分(=0.023),HOS-SS增加了34.03分(<0.001),NAHS增加了20.55分(=0.001),VAS降低了2.38分(<0.001)。接受HO切除翻修髋关节手术的患者预后评分改善,疼痛缓解;然而,很少有患者获得良好或优秀的结果。鉴于该患者群体的结果一般,HO切除翻修髋关节手术应谨慎进行。