Webb Mark S L, Devitt Brian M, O'Donnell John M
Hip Arthroscopy Australia, 21 Erin Street, Richmond, Victoria, Australia.
Trauma & Orthopaedic Department, St. George's Hospital, Blackshaw Road, London, UK.
J Hip Preserv Surg. 2019 Mar 19;6(1):50-54. doi: 10.1093/jhps/hnz005. eCollection 2019 Jan.
The operative treatment of pincer-type femoroacetabular impingement (FAI) has become an increasingly more common procedure. Classically, the labrum is incised at the chondrolabral junction (CLJ), or a concurrent tear is extended to allow access to the acetabular rim facilitating acetabuloplasty. The labrum is subsequently repaired using suture anchors. More recently, acetabuloplasty has been performed without incising the labrum and negating the need to use suture anchors. The aim of this study is to determine whether preserving the CLJ reduces the incidence of revision hip arthroscopy for the treatment of capsulolabral adhesions. This retrospective study compared two cohorts of patients undergoing hip arthroscopy for pincer-type FAI from August 2002 to April 2015. The groups analysed were patients undergoing acetabuloplasty with labral repair (LR) and those with no labral repair (NLR). The revision rates and causes for revision were compared using the χ analysis. There were 1010 cases in total. Acetabuloplasty with LR was performed in 546 hips (519 patients), while acetabuloplasty with NLR was performed in 464 hips (431 patients). In the LR group, there were 54 (9.9%) revisions, 25 (46%) of which were due to capsulolabral adhesions. The NLR group had 36 (7.8%) revisions with six (17%) due to capsulolabral adhesions. Preserving the CLJ, thereby avoiding the need for drilling and the insertion of suture anchors, when performing an acetabuloplasty for pincer-type FAI, significantly reduces the rate of symptomatic adhesions requiring revision arthroscopy.
钳夹型股骨髋臼撞击症(FAI)的手术治疗已成为一种越来越常见的手术。传统上,在软骨盂唇交界(CLJ)处切开盂唇,或将同时存在的撕裂口扩大,以便进入髋臼边缘,利于进行髋臼成形术。随后使用缝合锚钉修复盂唇。最近,在不切开盂唇且无需使用缝合锚钉的情况下进行了髋臼成形术。本研究的目的是确定保留CLJ是否能降低因治疗关节囊盂唇粘连而进行髋关节镜翻修手术的发生率。这项回顾性研究比较了2002年8月至2015年4月因钳夹型FAI接受髋关节镜检查的两组患者。分析的组为接受髋臼成形术并进行盂唇修复(LR)的患者和未进行盂唇修复(NLR)的患者。使用χ分析比较翻修率和翻修原因。总共1010例病例。546髋(519例患者)进行了LR髋臼成形术,464髋(431例患者)进行了NLR髋臼成形术。在LR组中,有54例(9.9%)进行了翻修,其中25例(46%)是由于关节囊盂唇粘连。NLR组有36例(7.8%)进行了翻修,6例(17%)是由于关节囊盂唇粘连。在对钳夹型FAI进行髋臼成形术时,保留CLJ,从而避免钻孔和插入缝合锚钉,可显著降低因有症状粘连而需要进行翻修关节镜检查的发生率。