Dai Zhu, Chen Zhiwei, Liao Ying, Tang Zhengwu, Cui Juncheng
Department of Orthopaedics, The First Affiliated Hospital of University of South China, Hengyang, Hunan - China.
Hip Int. 2018 Mar;28(2):173-177. doi: 10.1177/1120700017754013.
To compare the outcomes of contracture release by arthroscopic versus open surgical approach in patients with external snapping hip (ESH) caused by gluteal muscle contracture (GMC).
Medical records of patients with ESH due to GMC who underwent open surgery (n = 44) or arthroscopic surgery (n = 48) between October 2008 and October 2014 were reviewed. Patients were followed up at 1, 3, 12, and 24 months postoperatively. Operation time, incision length, postoperative pain, postoperative complication rate, and recurrence rate were compared between the 2 groups. Hip adduction, and Harris Hip Scores (HHS) at 1 and 2 years postoperatively were compared between the groups and with preoperative data.
Mean operation time did not differ between the 2 groups (p>0.05). The arthroscopic surgery group had smaller incisions (p<0.05), less postoperative pain (p<0.05), lower complication rates (p<0.05) than did the open surgery group. The recurrence rates were similar for the 2 groups (p>0.05). Hip adduction, and HHS 1 year and 2 years postoperatively were significantly better postoperatively than they had been preoperatively for both groups (all p<0.01), and were similar for the 2 groups (all p>0.05).
Arthroscopic release of contracture tissue is a safe and effective approach for the treatment of ESH caused by GMC, with the advantages of small scars, less postoperative pain, fewer complications compared with open surgery.
比较关节镜手术与开放手术治疗臀肌挛缩(GMC)所致臀肌外弹响髋(ESH)的疗效。
回顾性分析2008年10月至2014年10月间因GMC导致ESH而行开放手术(n = 44)或关节镜手术(n = 48)的患者的病历资料。术后1、3、12和24个月对患者进行随访。比较两组患者的手术时间、切口长度、术后疼痛、术后并发症发生率及复发率。比较两组患者术后1年和2年的髋关节内收情况及Harris髋关节评分(HHS),并与术前数据进行对比。
两组患者的平均手术时间无差异(p>0.05)。关节镜手术组的切口更小(p<0.05),术后疼痛更轻(p<0.05),并发症发生率低于开放手术组(p<0.05)。两组的复发率相似(p>0.05)。两组患者术后1年和2年的髋关节内收情况及HHS均显著优于术前(均p<0.01),且两组间相似(均p>0.05)。
关节镜下挛缩组织松解术是治疗GMC所致ESH的一种安全有效的方法,与开放手术相比,具有瘢痕小、术后疼痛轻、并发症少的优点。