Ashberg Lyall, Walsh John P, Yuen Leslie C, Perets Itay, Chaharbakhshi Edwin O, Domb Benjamin G
American Hip Institute, Westmont.
Hinsdale Orthopaedics, Hinsdale, IL.
J Pediatr Orthop. 2018 Feb;38(2):e50-e56. doi: 10.1097/BPO.0000000000001094.
Hip arthroscopy has been shown to be effective in managing various hip pathologies, including labral tears in adolescent patients. The purpose of this study was to ascertain whether outcomes of hip arthroscopy in patients under the age of 18 treated for labral tears differ depending on whether the presentation was acute or chronic. We also present the outcomes of the largest prospectively collected study on hip arthroscopy performed for labral tears in adolescents.
Patient reported outcome scores (PROs) for 194 patients undergoing hip arthroscopy for hip pathology, who were 18 or under at the time of surgery were prospectively collected and retrospectively reviewed. Modified Harris hip score (mHHS), Nonarthritic hip score (NAHS), Hip Outcome score-sport specific scale (HOS-SSS) and Visual Analogue Score (VAS) were the PROs collected. The overall cohort was assessed for outcome and a comparison was made between those patients who presented with acute onset of symptoms versus those who presented with insidious onset.
There was significant improvement in all the PROs for the overall cohort, with improvement maintained over an average of 38.5 months. There was no significant difference in outcome scores, between the acute and chronic groups except for change in VAS. Preoperative scores in the acute group were significantly lower, while postoperative scores did not differ. A trend toward more improvement was noted for the acute group. Overall need for revision surgery was 12%, with a higher rate of revision in the acute group.
Hip arthroscopy in adolescent patients being treated for intra-articular pathology is a safe procedure with favorable outcomes at minimum 2-year follow-up, with no significant difference in final outcomes between patients with acute onset of symptoms as opposed to those with more a more chronic presentation. Reoperation rate may be higher in patients with an acute onset.
Level II.
髋关节镜检查已被证明在处理各种髋关节病变方面有效，包括青少年患者的盂唇撕裂。本研究的目的是确定18岁以下因盂唇撕裂接受髋关节镜检查的患者，其结果是否因症状表现为急性或慢性而有所不同。我们还展示了针对青少年盂唇撕裂进行的最大规模前瞻性收集的髋关节镜检查研究的结果。
前瞻性收集并回顾性分析了194例因髋关节病变接受髋关节镜检查且手术时年龄在18岁及以下患者的患者报告结局评分（PROs）。收集的PROs包括改良Harris髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）、髋关节结局评分 - 运动特定量表（HOS - SSS）和视觉模拟评分（VAS）。对整个队列进行结局评估，并比较症状急性发作的患者与隐匿性发作的患者。
整个队列的所有PROs均有显著改善，平均38.5个月内持续改善。除VAS变化外，急性组和慢性组的结局评分无显著差异。急性组术前评分显著更低，而术后评分无差异。急性组有更明显的改善趋势。翻修手术的总体需求为12%，急性组的翻修率更高。
因关节内病变接受治疗的青少年患者进行髋关节镜检查是一种安全的手术，至少2年随访时有良好的结局，症状急性发作的患者与症状更慢性的患者最终结局无显著差异。急性发作患者的再次手术率可能更高。
二级。
