Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A..
Arthroscopy. 2019 Apr;35(4):1074-1079.e1. doi: 10.1016/j.arthro.2018.10.128. Epub 2019 Mar 8.
To examine the prevalence of concomitant symptomatic glenoid labral tears in patients with femoroacetabular impingement (FAI) in comparison to a control group of patients undergoing anterior cruciate ligament (ACL) reconstruction.
We retrospectively identified 1,644 patients who underwent femoroacetabular osteoplasty (FAO) and labrum repair from January 2007 to September 2016 and 1,055 patients who underwent arthroscopic ACL reconstruction from January 2012 to December 2014, which acted as our control group. An electronic questionnaire, including 8 questions regarding history of shoulder pathology, was sent to all patients in both groups. Symptomatic shoulder labral tears were identified on the basis of a positive magnetic resonance imaging scan or history of labral repair by reviewing patients' medical records and the filled questionnaire. Continuous variables were compared by use of a Mann-Whitney U test, and categorical variables were compared using Fisher's exact test. The Holm-Bonferroni sequential correction method was used to adjust P values for multiple comparisons of the presence of shoulder pathology.
A total of 443 patients (405 cam lesion) in the FAO group and 307 patients in the ACL reconstruction group completed the prepared questionnaire and were included in the study. Patients in the FAO group were slightly older (36.3 years [range, 15.4-61.7] vs 32.3 years [range, 16.3-75.7]) and more commonly female in the FAO group (58.0%, n = 257) compared with those in the ACL group (48.9%, n = 150). The prevalence of shoulder labral tear was 12.0% (95% confidence interval [CI], 9.3%-15.3%) for the FAO group compared with only 3.3% (95% CI, 1.8%-5.9%) for the ACL group. This represents a 3.7-fold (95% CI, 1.9-7.1) increase in the risk of shoulder labral tear for patients in the FAO group. Furthermore, shoulder labral tears were reported to be traumatic in only 43.4% of patients in the FAO group compared with 80.0% of patients in the ACL group. A similar proportion of patients in both groups (66.0% for FAO vs 60.0% for ACL) underwent a shoulder labral repair procedure.
There appears to be an association between acetabular labral tear caused by FAI and shoulder labral lesions. Patients in the FAI group had a 3.7-fold increase in the risk of shoulder labral tear compared with the ACL group. Future studies are needed to examine a possible cause behind the current findings.
Level III, comparative trial study.
与接受前交叉韧带（ACL）重建的对照组患者相比，研究患有股骨髋臼撞击症（FAI）患者中同时存在症状性盂唇撕裂的患病率。
我们回顾性地确定了 2007 年 1 月至 2016 年 9 月期间接受股骨髋臼成形术（FAO）和盂唇修复的 1644 例患者，以及 2012 年 1 月至 2014 年 12 月期间接受关节镜 ACL 重建的 1055 例患者作为对照组。我们向两组所有患者发送了一份包含 8 个有关肩部病理病史问题的电子问卷。根据磁共振成像扫描阳性或病史盂唇修复，通过查阅患者病历和填写的问卷来确定症状性肩盂唇撕裂。使用 Mann-Whitney U 检验比较连续变量，使用 Fisher 确切检验比较分类变量。使用 Holm-Bonferroni 顺序校正法对存在肩部病变的多个比较的 P 值进行调整。
FAO 组共有 443 例患者（405 例凸轮病变）和 ACL 重建组的 307 例患者完成了准备好的问卷并被纳入研究。FAO 组患者的年龄稍大（36.3 岁[范围，15.4-61.7]比 ACL 组的 32.3 岁[范围，16.3-75.7]），并且 FAO 组中女性更为常见（58.0%，n=257）比 ACL 组（48.9%，n=150）。FAO 组的肩盂唇撕裂患病率为 12.0%（95%置信区间[CI]，9.3%-15.3%），而 ACL 组仅为 3.3%（95%CI，1.8%-5.9%）。这代表 FAO 组患者肩盂唇撕裂的风险增加了 3.7 倍（95%CI，1.9-7.1）。此外，在 FAO 组中，只有 43.4%的肩盂唇撕裂患者报告为创伤性，而 ACL 组中这一比例为 80.0%。两组中相似比例的患者（FAO 为 66.0%，ACL 为 60.0%）接受了肩盂唇修复手术。
似乎存在由 FAI 引起的髋臼唇撕裂与肩盂唇病变之间的关联。与 ACL 组相比，FAI 组患者肩盂唇撕裂的风险增加了 3.7 倍。需要进一步的研究来检查当前发现背后的可能原因。
III 级，对比试验研究。
