Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A..
Arthroscopy. 2019 Feb;35(2):631-643. doi: 10.1016/j.arthro.2018.08.055. Epub 2019 Jan 4.
To compare outcomes of hip arthroplasty in patients with and without a history of hip arthroscopy through a systematic review.
A comprehensive search of the PubMed (MEDLINE) and Cochrane Central databases was performed using combinations of the keywords "hip," "arthroscopy," "arthroscopic," "arthroplasty," "replacement," and "conversion" in December 2017. Level I through III studies directly comparing outcomes of total or resurfacing hip arthroplasty between patients with and without a history of hip arthroscopy were included in this review if they reported at least 1 outcome measure.
Seven retrospective case-control studies collectively evaluating arthroplasty outcomes of 235 patients (104 male and 131 female patients) with a history of hip arthroscopy and 374 matched controls met the inclusion criteria. The mean age in the arthroscopy and control groups was 47.2 years and 49.1 years, respectively. The mean follow-up period after arthroplasty was 3.2 years in the hip arthroscopy group and 3.3 years in the control group. The mean time between arthroscopy and arthroplasty was 1.8 years. A posterior approach was used in 83.6% of arthroplasties. No statistically significant differences were noted in intraoperative measures, postoperative complications, or revision rates, with the exception of 1 study that reported an increased operative time among controls. Most studies reported similar subjective outcomes between groups, with a single study noting worse postoperative findings for the Harris Hip Score, Forgotten Joint Score-12, visual analog scale pain score, and patient satisfaction in the prior hip arthroscopy group.
The current literature suggests that short-term and midterm outcomes of hip arthroplasty are comparable in patients with and without a history of hip arthroscopy. However, the available literature is limited given the small sample sizes and therefore greater potential for β error. Nevertheless, our findings may be useful for surgeons evaluating risks and prognoses in this patient population.
Level III, systematic review of Level III studies.
通过系统评价比较有和无髋关节镜检查史的髋关节置换术患者的结局。
2017 年 12 月，我们通过组合使用“髋关节”、“关节镜”、“关节镜检查”、“关节置换术”、“置换”和“转换”等关键词，对 PubMed（MEDLINE）和 Cochrane 中央数据库进行了全面检索。如果研究报告了至少 1 项结局测量指标，且直接比较了有和无髋关节镜检查史的患者全髋关节置换术或表面置换术的结局，则将其纳入本综述的 I 级至 III 级研究。
共有 7 项回顾性病例对照研究，共纳入 235 例（男 104 例，女 131 例）有髋关节镜检查史患者和 374 例匹配对照者，符合纳入标准。关节镜组和对照组的平均年龄分别为 47.2 岁和 49.1 岁。关节镜组和对照组的平均术后随访时间分别为 3.2 年和 3.3 年。髋关节镜组中 83.6%的患者采用了后路入路。除 1 项研究报告对照组的手术时间延长外，两组在术中指标、术后并发症或翻修率方面无统计学差异。大多数研究报告两组的主观结局相似，仅有 1 项研究报告先前有髋关节镜检查史的患者组在 Harris 髋关节评分、遗忘关节评分-12、视觉模拟评分疼痛和患者满意度方面的术后发现较差。
目前的文献表明，有和无髋关节镜检查史的患者髋关节置换术的短期和中期结局相似。然而，鉴于样本量较小，因此 β 错误的可能性更大，现有文献有限。尽管如此，我们的研究结果可能对评估该患者人群风险和预后的外科医生有用。
III 级，对 III 级研究的系统评价。
