American Hip Institute, Westmont, Illinois.
Department of Orthopedics, Chaim Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel.
J Arthroplasty. 2017 Dec;32(12):3665-3668. doi: 10.1016/j.arth.2017.06.050. Epub 2017 Jul 6.
Total hip arthroplasty (THA) is one of the most common reoperations after hip arthroscopy. Although arthroscopy causes changes in the hip joint and the surrounding soft tissues that can make THA more challenging, previous reports on arthroscopy before THA have not demonstrated any significant effect on clinical outcomes.
Patients who underwent a THA following an ipsilateral hip arthroscopy were matched to a control group of THA patients with no history of ipsilateral hip surgery. Matching criteria were age within 5 years, sex, body mass index within 5, surgical approach, and robotic assistance. Harris Hip Score, Forgotten Joint Score-12, visual analog scale score, satisfaction, and postoperative complication and reoperation rates were compared at minimum 2-year follow-up.
Thirty-five THA after arthroscopy patients were successfully matched to control patients. There were no significant differences in demographics between study groups. The THA after arthroscopy group had significantly lower Harris Hip Score, Forgotten Joint Score-12, and satisfaction at latest follow-up. They had higher visual analog scale score and complication rate in differences that closely approached significance. There was no significant difference in reoperation rate.
A prior hip arthroscopy may adversely affect the clinical outcomes of THA. This potential risk should be considered when assessing the candidacy of a patient for hip arthroscopy.
全髋关节置换术(THA)是髋关节镜检查后的最常见翻修手术之一。尽管关节镜检查会导致髋关节和周围软组织发生变化,从而使 THA 更具挑战性,但之前关于 THA 前关节镜检查的报告并未显示对临床结果有任何显著影响。
将接受同侧髋关节镜检查后行 THA 的患者与无同侧髋关节手术史的 THA 对照组患者相匹配。匹配标准为年龄相差 5 年以内、性别、体重指数相差 5 以内、手术入路和机器人辅助。在至少 2 年的随访时比较 Harris 髋关节评分、遗忘关节评分-12、视觉模拟评分、满意度以及术后并发症和再次手术率。
35 例接受关节镜检查后的 THA 患者成功与对照组患者相匹配。两组患者的人口统计学数据无显著差异。在最新随访时,关节镜检查后的 THA 组的 Harris 髋关节评分、遗忘关节评分-12 和满意度明显较低。他们的视觉模拟评分较高,且并发症发生率差异接近显著。再次手术率无显著差异。
髋关节镜检查可能会对 THA 的临床结果产生不利影响。在评估患者髋关节镜检查的适应证时,应考虑到这种潜在风险。