Adult Reconstruction and Joint Replacement Division (ARJR), The Hospital for Special Surgery, New York, NY.
J Arthroplasty. 2018 Jun;33(6):1806-1812. doi: 10.1016/j.arth.2018.01.012. Epub 2018 Feb 2.
BACKGROUND: A significant number of patients who undergo hip arthroscopy will subsequently undergo total hip arthroplasty (THA) or hip resurfacing arthroplasty (HRA), although limited evidence exists regarding effects of prior hip arthroscopy on the outcomes of these procedures. METHODS: Of 5091 patients who underwent hip arthroscopy, we identified 69 patients who underwent subsequent THA (46) or HRA (23). Patients were matched to patients with no history of hip arthroscopy. Preoperative and 2-year postoperative Hip disability and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-12, Lower Extremity Activity Scale score, and satisfaction surveys were compared. RESULTS: Patients who underwent THA with history of arthroscopy had lower postoperative Hip disability and Osteoarthritis Outcome Score Pain (82 ± 16 vs 93 ± 9, P = .003), Stiffness (85 ± 16 vs 93 ± 15, P = .01), Sports and Recreation (71 ± 22 vs 88 ± 18, P = .003), Quality-of-Life (65 ± 22 vs 86 ± 11, P < .0001), WOMAC Pain (86 ± 16 vs 93 ± 15, P = .03), WOMAC Stiffness (80 ± 21 vs 88 ± 17, P = .05), and Short Form-12 Physical Component Scores (48 ± 11 vs 54 ± 6, P = .008). They were less likely to be "very satisfied" after arthroplasty (71% vs 89%, P = .0008). CONCLUSION: Hip arthroscopy before hip arthroplasty is associated with slightly lower results in several patient-reported outcomes. These results are relevant when assessing patients for hip arthroscopy and when counseling prospective arthroplasty patients with history of arthroscopy.
背景:尽管先前的髋关节镜检查对这些手术结果的影响的证据有限,但仍有相当数量的髋关节镜检查患者随后会接受全髋关节置换术(THA)或髋关节表面置换术(HRA)。
方法:在接受髋关节镜检查的 5091 名患者中,我们确定了 69 名随后接受 THA(46 例)或 HRA(23 例)的患者。这些患者与没有髋关节镜检查史的患者相匹配。比较了术前和术后 2 年的髋关节残疾和骨关节炎结果评分(HHS)、西部安大略省和麦克马斯特大学骨关节炎指数(WOMAC)、简化健康调查量表 12 项(SF-12)、下肢活动量表评分和满意度调查。
结果:有髋关节镜检查史的 THA 患者术后髋关节残疾和骨关节炎结果评分疼痛(82 ± 16 对 93 ± 9,P =.003)、僵硬(85 ± 16 对 93 ± 15,P =.01)、运动和娱乐(71 ± 22 对 88 ± 18,P =.003)、生活质量(65 ± 22 对 86 ± 11,P <.0001)、WOMAC 疼痛(86 ± 16 对 93 ± 15,P =.03)、WOMAC 僵硬(80 ± 21 对 88 ± 17,P =.05)和 SF-12 生理成分评分(48 ± 11 对 54 ± 6,P =.008)较低。他们在接受关节置换术后更不可能“非常满意”(71%对 89%,P =.0008)。
结论:髋关节镜检查前的髋关节镜检查与几个患者报告的结果略有降低有关。在评估髋关节镜检查患者和咨询有髋关节镜检查史的潜在关节置换患者时,这些结果具有重要意义。
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