Spiker Andrea M, Rotter Ben-Zion, Chang Brenda, Mintz Douglas N, Kelly Bryan T
Department of Orthopedic Surgery, Sports Medicine and Hip Preservation, University of Wisconsin-Madison, Madison, WI, USA.
Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E. 70th St, New York, NY 10021, USA and.
J Hip Preserv Surg. 2017 Dec 28;5(1):88-99. doi: 10.1093/jhps/hnx042. eCollection 2018 Jan.
Intra-articular osteoid osteoma (IAOO) of the hip is a relatively rare diagnosis, but one that can closely mimic symptomatic presentation of femoroacetabular impingement (FAI). Although there are multiple case reports of osteoid osteoma (OO) in the hip, we present the largest case series of hip IAOO treated with hip arthroscopy and discuss limited patient-reported outcomes after treatment with hip arthroscopy. We retrospectively identified patients diagnosed with IAOO of the hip with confirmatory computed tomography, magnetic resonance imaging or biopsy diagnoses of OO. We analyzed lesion location, main presenting symptoms, symptom duration and treatment undertaken. For the patients who underwent hip arthroscopy for treatment of their IAOO, we reviewed patient-reported outcome scores when available. Forty patients with confirmed IAOO were identified. Thirteen underwent excision with hip arthroscopy. The most common presenting symptom was groin pain. In limited patients who had pre- and post-operative outcome scores, we found significant improvements in modified Harris Hip Score (mHHS), Hip Outcome Score-Activity of Daily Living (HOS-ADL) and international Hip Outcomes Tool (iHot33) scores. Compared with patients undergoing hip arthroscopy for FAI alone, baseline mHHS, HOS-ADL, Hip Outcome Score-Sport-Specific Subscale and iHot33 scores were almost identical. We found that the presenting symptoms of hip IAOO closely mimic symptomatic FAI, including groin pain and anterior hip pain, so it is important to keep IAOO of the hip in the differential diagnosis of hip pain. Based on our experience, arthroscopy can be an effective treatment option for excision of intra-articular OO and is especially effective in patients with concomitant FAI in treating both pathologies.
髋关节内骨样骨瘤（IAOO）是一种相对罕见的诊断，但它可能与股骨髋臼撞击症（FAI）的症状表现极为相似。尽管已有多篇关于髋关节骨样骨瘤（OO）的病例报告，但我们呈现了接受髋关节镜治疗的最大规模髋关节IAOO病例系列，并讨论了髋关节镜治疗后有限的患者报告结局。我们通过计算机断层扫描、磁共振成像或活检确诊为OO，回顾性地确定了诊断为髋关节IAOO的患者。我们分析了病变位置、主要症状表现、症状持续时间以及所采取的治疗方法。对于接受髋关节镜治疗IAOO的患者，我们在可获取的情况下回顾了患者报告的结局评分。确定了40例确诊为IAOO的患者。其中13例接受了髋关节镜下切除。最常见的症状表现是腹股沟疼痛。在有限的有术前和术后结局评分的患者中，我们发现改良Harris髋关节评分（mHHS）、髋关节结局评分 - 日常生活活动（HOS - ADL）和国际髋关节结局工具（iHot33）评分有显著改善。与仅因FAI接受髋关节镜治疗的患者相比，基线mHHS、HOS - ADL、髋关节结局评分 - 运动特定子量表和iHot33评分几乎相同。我们发现髋关节IAOO的症状表现与有症状的FAI极为相似，包括腹股沟疼痛和髋关节前部疼痛，因此在髋关节疼痛的鉴别诊断中考虑髋关节IAOO很重要。基于我们的经验，关节镜检查可以是切除关节内OO的有效治疗选择，对于同时患有FAI的患者在治疗两种病症时尤其有效。
