Kim Hee Joong, Yoo Jeong Joon, Kwak Hong Suk, Jeong Hyung Jun, Kim Min Nyeon, Seo Wonyeong
1 Medical Research Center, Seoul National University, Seoul, Korea.
2 Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea.
J Orthop Surg (Hong Kong). 2017 Sep-Dec;25(3):2309499017745732. doi: 10.1177/2309499017745732.
Adhesive capsulitis of the hip (ACH) is not a well-defined disease entity. We evaluated the change in the clinical features of patients whose chief complaint was inability to sit cross-legged on the floor. All patients had painful limitation in hip joint motion. Based on the diagnosis of ACH, active stretching exercise (ASE) was recommended.
In February 2013 and June 2014, a total of 44 patients (50 hips), who visited outpatient clinic in 2011, were evaluated by telephone interviews. Recovery of hip motion was analyzed according to compliance with ASE and abnormalities found on plane radiographs and magnetic resonance (MR) images.
There were 27 women and 17 men with mean age of 51.7 years. In the first telephone interview, 40 patients (45 hips) reported improvement in hip motion but 4 patients (5 hips) reported absolutely no improvement. Compliance with ASE did not affect recovery of motion ( p = 0.225). On plain radiographs, 10 patients (22.7%) had abnormal finding in both hips. Those abnormal findings were not correlated with symptom and did not show adverse effect on motion recovery. Sixteen patients took MR images outside, and abnormal findings such as round ligament or labral tear were observed in nine patients. Those abnormal findings neither correlated with the symptom nor affected motion recovery adversely. In the second telephone interview, nine hips of further improvement and two hips of recurrence were identified.
Most cases showed improvement in the range of motion with or without ASE. Surgical treatments including arthroscopy seemed to be unnecessary for these patients.
髋关节粘连性关节囊炎（ACH）并非一种定义明确的疾病实体。我们评估了以无法盘腿坐在地上为主诉的患者临床特征的变化。所有患者髋关节活动均有疼痛性受限。基于ACH的诊断，建议进行主动伸展运动（ASE）。
2013年2月和2014年6月，通过电话访谈对2011年就诊于门诊的44例患者（50髋）进行了评估。根据ASE的依从性以及X线平片和磁共振（MR）图像上发现的异常情况分析髋关节活动的恢复情况。
有27名女性和17名男性，平均年龄51.7岁。在首次电话访谈中，40例患者（45髋）报告髋关节活动有所改善，但4例患者（5髋）报告完全没有改善。ASE的依从性并未影响活动恢复（p = 0.225）。在X线平片上，10例患者（22.7%）双侧髋关节有异常表现。这些异常表现与症状无关，对活动恢复也未显示出不利影响。16例患者在外院进行了MR检查，9例患者观察到诸如圆韧带或盂唇撕裂等异常表现。这些异常表现既与症状无关，也未对活动恢复产生不利影响。在第二次电话访谈中，发现9髋进一步改善，2髋复发。
大多数病例无论是否进行ASE，活动范围均有改善。对于这些患者，包括关节镜检查在内的手术治疗似乎没有必要。
