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关节镜髋关节翻修手术的临床结果和原因。

Clinical outcomes and causes of arthroscopic hip revision surgery.

机构信息

Institute of Sports Medicine, Peking University Third Hospital, Peking University Health Science Center, Beijing, China.

出版信息

Sci Rep. 2019 Feb 4;9(1):1230. doi: 10.1038/s41598-018-37708-y.

Abstract

Hip arthroscopic surgery has become a common technique during the past decade, leading to an increased number of arthroscopic hip revision surgeries. This study aimed to evaluate the clinical outcomes in a series of revision hip arthroscopies to analyse the causes of reoperation in the short to medium-term follow-up. We retrospectively analysed 22 patients who underwent arthroscopic hip revision surgery in our institute. All patients accepted a detailed physical examination and obtained radiographs to measure the centre edge angle, the alpha angle and the offset. Three-dimensional computed tomography was used to evaluate the deformities. The modified Harris Hip Score, visual analogue scale and patient self-reported satisfaction were collected and analysed preoperatively and postoperatively. Our results demonstrated that the modified Harris Hip Score improved from 52.8 to 81.6, and the visual analogue scale decreased from 5.0 to 1.1. Patient self-reported satisfaction was 8.5. In conclusion, patients who underwent arthroscopic hip revision surgery exhibited significant improvement in patient-centred outcomes in the short- to medium-term follow-up, and the outcomes indicated the effectiveness of revision surgery. Residual femoroacetabular impingement and extra-articular impingement are common reasons for arthroscopic hip revision surgery. Misdiagnosis of osteoid osteoma and relapse of synovial chondromatosis are also important reasons for revision.

摘要

髋关节镜手术在过去十年中已成为一种常见技术,由此导致髋关节镜翻修手术的数量增加。本研究旨在评估一系列髋关节镜翻修手术的临床结果,以分析短期至中期随访中再次手术的原因。我们回顾性分析了在我们研究所接受髋关节镜翻修手术的 22 名患者。所有患者均接受详细的体格检查和影像学检查,以测量中心边缘角、α角和偏移量。使用三维 CT 评估畸形。收集并分析术前和术后改良 Harris 髋关节评分、视觉模拟评分和患者自我报告满意度。我们的结果表明,改良 Harris 髋关节评分从 52.8 分提高到 81.6 分,视觉模拟评分从 5.0 分降低到 1.1 分。患者自我报告满意度为 8.5。总之,接受髋关节镜翻修手术的患者在短期至中期随访中患者为中心的结果显著改善,结果表明翻修手术的有效性。残余的股骨髋臼撞击和关节外撞击是髋关节镜翻修手术的常见原因。骨样骨瘤的误诊和滑膜软骨瘤病的复发也是翻修的重要原因。

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