Pergaminelis Nicholas, Renouf Jesse, Fary Camdon, Tirosh Oren, Tran Phong
Orthopaedic Department, Western Health, Footscray, VIC, 3011, Australia.
The University of Melbourne, Parkville, VIC, Australia.
BMC Musculoskelet Disord. 2017 Dec 29;18(1):554. doi: 10.1186/s12891-017-1905-6.
Tears of the Ligamentum Teres are a common cause of groin pain. Tears of the ligament frequently co-exist alongside other bony or labral intra-articular hip lesions, which are also treated at the time of arthroscopy. For this reason, it is often difficult to assess the effect that debridement alone has on improving patient pain and function. This study aims to assess the short-term outcomes of arthroscopic debridement of isolated Ligamentum Teres tears using a validated patient-reported outcome score - the International Hip Outcome Tool (iHOT-33).
A retrospective review was performed of 35 patients (37 hips) who had an isolated Ligamentum Teres tear treated with arthroscopic radiofrequency debridement between September 2012 and September 2015. Patients with concomitant intra-articular hip pathology (femoroacetabular impingement, labral lesions, hip dysplasia) were excluded from the study. All patients completed the iHOT-33 questionnaire pre-operatively and post-operatively. The mean age was 37.7 years (range 16-67 years) and patients were followed up for a mean period of 17.7 months (range 6-42 months). Thirty-one patients were female and 4 were male.
Thirty-seven isolated partial tears were managed with arthroscopic radiofrequency debridement. At follow up, the mean iHOT-33 score improved from 26.9 pre-operatively to 48.0 post-operatively, representing a mean improvement of 21.1 (p < 0.001). The minimum clinically important difference of the iHOT-33 is 6.1 points. Significant improvements were noted in all four sub-sections of the iHOT-33.
Arthroscopic radiofrequency debridement of isolated Ligamentum Teres tears provides short-term benefit in the majority of patients, including significant improvement in sporting function.
圆韧带撕裂是腹股沟疼痛的常见原因。该韧带撕裂常与其他髋关节内的骨性或盂唇病变同时存在，这些病变在关节镜检查时也会得到治疗。因此，往往难以评估单纯清创术对改善患者疼痛和功能的效果。本研究旨在使用经过验证的患者报告结局评分——国际髋关节结局工具（iHOT-33）来评估关节镜下孤立性圆韧带撕裂清创术的短期疗效。
对2012年9月至2015年9月间接受关节镜下射频清创术治疗孤立性圆韧带撕裂的35例患者（37髋）进行回顾性研究。排除伴有髋关节内病变（股骨髋臼撞击症、盂唇病变、髋关节发育不良）的患者。所有患者在术前和术后均完成iHOT-33问卷。平均年龄为37.7岁（范围16 - 67岁），患者平均随访17.7个月（范围6 - 42个月）。31例为女性，4例为男性。
37例孤立性部分撕裂采用关节镜下射频清创术治疗。随访时，iHOT-33评分平均从术前的26.9分提高到术后的48.0分，平均提高21.1分（p < 0.001）。iHOT-33的最小临床重要差异为6.1分。iHOT-33的所有四个子部分均有显著改善。
关节镜下射频清创术治疗孤立性圆韧带撕裂对大多数患者有短期益处，包括运动功能的显著改善。
