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髋关节镜检查和关节囊折叠术治疗股骨髋臼撞击综合征后,有或无关节活动过度的女性患者报告的可比结局。

Comparable patient-reported outcomes in females with or without joint hypermobility after hip arthroscopy and capsular plication for femoroacetabular impingement syndrome.

作者信息

Stone Austin V, Mehta Nabil, Beck Edward C, Waterman Brian R, Chahla Jorge, Ukwuani Gift, Nho Shane J

机构信息

Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Department of Orthopedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.

出版信息

J Hip Preserv Surg. 2019 Mar 14;6(1):33-40. doi: 10.1093/jhps/hnz004. eCollection 2019 Jan.

Abstract

Hip arthroscopy is widely utilized to treat femoroacetabular impingement syndrome (FAIS). In order to evaluate the postoperative clinical and functional outcomes at 2-year follow up in patients with and without benign joint hypermobility syndrome following hip arthroscopy with capsular plication for FAIS, consecutive female patients with generalized ligamentous laxity undergoing primary hip arthroscopy with complete T-capsulotomy closure via plication for FAIS were prospectively identified. Patients were matched in a 4:1 ratio based on Beighton-Horan joint mobility index (BHJMI) then classified into no generalized joint laxity (NGJL, Score<4) or generalized joint laxity cohort (GJL, Score=4). Patient and surgical-related factors were analyzed using univariate and paired analysis with statistical significance set at a = 0.05. A total of 125 female patients were included in the study: 25 generalized joint laxity (GJL) patients and 100 matched to age, sex and BMI (NGJL cohort). The results demonstrated that there were no significant differences between demographics, preoperative range of motion, or radiographic analysis on univariate analysis. There was no statistical difference in postoperative range of motion between groups, though both groups demonstrated significant increases in postoperative flexion and postoperative internal rotation following hip arthroscopy. Paired analysis demonstrated no significant difference in HOS-SS, HOS-ADL, mHHS or VAS-pain, while GJL patients reported significantly greater patient satisfaction score at 2-years follow-up (p=0.007). In summary, hip arthroscopy with capsular plication is a highly effective treatment for FAIS in patients with and without generalized joint laxity. In our analysis, patients with and without generalized joint laxity demonstrated statistically similar and significant improvement in outcomes.

摘要

髋关节镜检查被广泛用于治疗股骨髋臼撞击综合征(FAIS)。为了评估在对FAIS行髋关节镜下关节囊折叠术后2年随访时,有无良性关节过度活动综合征患者的术后临床和功能结果,前瞻性地纳入了连续的因FAIS接受初次髋关节镜下完全T形关节囊切开并通过折叠术闭合的女性全身韧带松弛患者。根据Beighton-Horan关节活动指数(BHJMI)以4:1的比例对患者进行匹配,然后分为无全身关节松弛(NGJL,评分<4)或全身关节松弛队列(GJL,评分=4)。使用单因素分析和配对分析对患者及手术相关因素进行分析,设定统计学显著性为α=0.05。共有125名女性患者纳入研究:25名全身关节松弛(GJL)患者和100名在年龄、性别和BMI方面匹配的患者(NGJL队列)。结果表明,单因素分析时,人口统计学、术前活动范围或影像学分析之间无显著差异。尽管两组在髋关节镜检查术后的屈曲和内旋均有显著增加,但两组术后活动范围无统计学差异。配对分析显示,髋关节结果评分量表-症状严重程度(HOS-SS)、髋关节结果评分量表-日常生活活动(HOS-ADL)、改良Harris髋关节评分(mHHS)或视觉模拟评分法疼痛评分(VAS-疼痛)无显著差异,而GJL患者在2年随访时报告的患者满意度评分显著更高(p=0.007)。总之,关节囊折叠术的髋关节镜检查对有无全身关节松弛的FAIS患者都是一种非常有效的治疗方法。在我们的分析中,有无全身关节松弛的患者在结果方面均有统计学上相似且显著的改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2d/6501436/56071cdb9169/hnz004f1.jpg

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