Carreira Dominic S, Kruchten Matthew C, Emmons Brendan R, Martin RobRoy L
Peachtree Orthopedics, 3200 Downwood Circle NW Suite 700, Atlanta, GA, USA.
Florida Institute of Orthopaedic Surgical Specialists, 2307 W Broward Blvd Suite 200, Fort Lauderdale, FL, USA.
J Hip Preserv Surg. 2018 Aug 10;5(3):247-258. doi: 10.1093/jhps/hny028. eCollection 2018 Aug.
The purpose of this study was to describe the shuttle technique of acetabular labral reconstruction using allograft fascia lata and report minimum two-year clinical outcomes in a prospective patient cohort. We present a shuttle technique to introduce and fixate the allograft, by which the need to fix the free end of the graft from inside the joint is avoided. Between October 2010 and March 2014, 693 hip arthroscopic surgeries were performed by the senior author. Of these 693 patients, 34 patients underwent a labral reconstruction procedure using allograft fascia lata and the shuttle technique and met inclusion criteria. Outcome measures were collected at minimum two years postoperatively. 91.2% (31) of reconstruction patients were available for follow-up at minimum two years after surgery with 12.9% (4) of these patients converting to total hip arthroplasty at average time 27.9 months post-surgery. For the remaining reconstruction patients, mean mHHS increased from 64.0 preoperatively to 84.6 postoperatively ( = 0.0015), SF-12 Physical from 38.9 to 49.0 ( = 0.0004), SF-12 Mental from 49.5 to 55.6 ( = 0.0095), iHOT-12 from 36.4 to 68.1 ( = 0.0017), HOS-ADL from 62.6 to 81.6 ( = 0.0032) and HOS-SS from 32.9 to 65.7 ( < 0.0001). Arthroscopic acetabular labral reconstruction using fascia lata allograft and a shuttle technique appears to be an effective procedure for the treatment of labral pathology through minimum two-year follow-up. While it is difficult to discern the direct influence of the labral reconstructive procedure given the treatment of often concomitant intra-articular pathology, this patient cohort has fared similarly to other cohorts of labral reconstruction patients. No major adverse events are reported.
本研究的目的是描述使用同种异体阔筋膜进行髋臼盂唇重建的穿梭技术，并报告一个前瞻性患者队列中至少两年的临床结果。我们提出了一种引入和固定同种异体移植物的穿梭技术，借此避免了从关节内部固定移植物游离端的需求。2010年10月至2014年3月期间，资深作者共进行了693例髋关节镜手术。在这693例患者中，34例患者采用同种异体阔筋膜和穿梭技术进行了盂唇重建手术，并符合纳入标准。术后至少两年收集结果指标。91.2%（31例）的重建患者在术后至少两年可进行随访，其中12.9%（4例）的患者在术后平均27.9个月时转为全髋关节置换术。对于其余的重建患者，平均改良Harris髋关节评分（mHHS）从术前的64.0提高到术后的84.6（P = 0.0015），SF-12身体维度评分从38.9提高到49.0（P = 0.0004），SF-12心理维度评分从49.5提高到55.6（P = 0.0095），iHOT-12评分从36.4提高到68.1（P = 0.0017），髋关节功能评定量表日常生活活动（HOS-ADL）评分从62.6提高到81.6（P = 0.0032），髋关节功能评定量表运动功能（HOS-SS）评分从32.9提高到65.7（P < 0.0001）。通过至少两年的随访，使用同种异体阔筋膜和穿梭技术进行关节镜下髋臼盂唇重建似乎是治疗盂唇病变的有效方法。鉴于通常同时存在关节内病变的治疗情况，很难辨别盂唇重建手术的直接影响，但该患者队列的情况与其他盂唇重建患者队列相似。未报告重大不良事件。
