Oduwole K O, de Sa D, Kay J, Findakli F, Duong A, Simunovic N, Yi-Meng Y, Ayeni O R
Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
Centre for Evidence Based Orthopaedics, McMaster University, Hamilton, Ontario, Canada.
Bone Joint Res. 2017 Aug;6(8):472-480. doi: 10.1302/2046-3758.68.BJR-2017-0018.R1. Epub 2017 Aug 8.
The purpose of this study was to evaluate the existing literature from 2005 to 2016 reporting on the efficacy of surgical management of patients with femoroacetabular impingement (FAI) secondary to slipped capital femoral epiphysis (SCFE).
The electronic databases MEDLINE, EMBASE, and PubMed were searched and screened in duplicate. Data such as patient demographics, surgical technique, surgical outcomes and complications were retrieved from eligible studies.
Fifteen eligible level IV studies were included in this review comprising 261 patients (266 hips). Treatment groups included arthroscopic osteochondroplasty, surgical hip dislocation, and traditional open osteotomy. The mean alpha angle corrections were 32.14° (standard deviation (sd) 7.02°), 41.45° (sd 10.5°) and 6.0° (sd 5.21°), for arthroscopy, surgical hip dislocation, and open osteotomy groups, respectively (p < 0.05). Each group demonstrated satisfactory clinical outcomes across their respective scoring systems. Major complication rates were 1.6%, 10.7%, and 6.7%, for arthroscopy, surgical dislocation and osteotomy treatments, respectively.
In the context of SCFE-related FAI, surgical hip dislocation demonstrated improved correction of the alpha angle, albeit at higher complication and revision rates than both arthroscopic and open osteotomy treatments. Further investigation, including high-quality trials with standardised radiological and clinical outcome measures for young patients, is warranted to clarify treatment approaches and safety.: K. O. Oduwole, D. de Sa, J. Kay, F. Findakli, A. Duong, N. Simunovic, Y. Yi-Meng, O. R. Ayeni. Surgical treatment of femoroacetabular impingement following slipped capital femoral epiphysis: A systematic review. 2017;6:472-480. DOI: 10.1302/2046-3758.68.BJR-2017-0018.R1.
本研究旨在评估2005年至2016年期间关于手术治疗继发于股骨头骨骺滑脱（SCFE）的股骨髋臼撞击症（FAI）患者疗效的现有文献。
对电子数据库MEDLINE、EMBASE和PubMed进行检索并重复筛选。从符合条件的研究中检索患者人口统计学、手术技术、手术结果和并发症等数据。
本综述纳入了15项符合条件的IV级研究，共261例患者（266髋）。治疗组包括关节镜下骨软骨成形术、手术性髋关节脱位和传统开放截骨术。关节镜组、手术性髋关节脱位组和开放截骨术组的平均α角矫正分别为32.14°（标准差（sd）7.02°）、41.45°（sd 10.5°）和6.0°（sd 5.21°）（p<0.05）。每组在各自的评分系统中均显示出满意的临床结果。关节镜治疗、手术脱位治疗和截骨术治疗的主要并发症发生率分别为1.6%、10.7%和6.7%。
在与SCFE相关的FAI背景下，手术性髋关节脱位显示出α角矫正效果更佳，尽管其并发症和翻修率高于关节镜和开放截骨术治疗。有必要进行进一步研究，包括针对年轻患者采用标准化放射学和临床结局指标的高质量试验，以明确治疗方法和安全性。：K.O.奥杜沃勒、D.德萨、J.凯、F.芬达克利、A.杜昂、N.西穆诺维奇、Y.易萌、O.R.阿耶尼。股骨头骨骺滑脱后股骨髋臼撞击症的手术治疗：系统评价。2017；6：472 - 480。DOI：10.1302/2046 - 3758.68.BJR - 2017 - 0018.R1。
