Faccioni Samuel, Cachoeira Vinicius Adelchi, Knop Gabriel Pozzobon, Silva Luiz Henrique Penteado, Knop Tercildo
Instituto de Ortopedia e Traumatologia, Hospital São Vicente de Paulo, Passo Fundo, RS, Brasil.
Rev Bras Ortop (Sao Paulo). 2019 Jul;54(4):434-439. doi: 10.1016/j.rbo.2018.04.003. Epub 2019 Aug 20.
The purpose of the present study was to evaluate factors associated with the presence of deep chondral lesions (Konan/Haddad grades III and IV) in patients submitted to hip arthroscopy to treat femoroacetabular impingement (FAI). This was a prospective, cross-sectional study of a series of 125 consecutive hip arthroscopies performed between May 2016 and May 2017. After applying the exclusion criteria, 107 hips of 92 patients submitted to surgical treatment for mixed and CAM FAI were analyzed. For purposes of analysis, the present study considered groups with lesions considered mild and deep, which were associated with symptom score, lateral coverage angle, α angle, age, gender, and radiological classification of arthrosis. Results with a -value < 0.05 were considered statistically significant. Patients whose hips had lesions considered deep had significantly higher nonarthritic hip scores (NAHSs) than those whose hips presented lesions considered mild or who did not present chondral lesions (67.9 ± 19.4 versus 57.0 ± 21.9, = 0.027). The prevalence of deep lesions was higher in hips with Tonnis 1 compared with hips with Tonnis 0: 15 (55.6%) versus 10 (12.7%), respectively, < 0.001. Men presented a higher prevalence of grades III and IV lesions than women, 23 (34.3%) versus 2 (5.0%), = 0.001, and had significantly higher functional scores (65.6 ± 19.6 versus 49.3 ± 21.6, < 0.001). Men presented a higher prevalence of deep lesions. Hips classified as Tonnis 1 presented a 4.4-fold higher probability of presenting these lesions. Patients with deep chondrolabral lesions had a better preoperative functional score.
本研究的目的是评估在接受髋关节镜检查以治疗股骨髋臼撞击症（FAI）的患者中，与深层软骨损伤（Konan/Haddad III级和IV级）存在相关的因素。 这是一项对2016年5月至2017年5月期间连续进行的125例髋关节镜检查的前瞻性横断面研究。应用排除标准后，对92例因混合型和钳夹型FAI接受手术治疗的患者的107髋进行了分析。为了分析目的，本研究将损伤分为轻度和深层两组，并将其与症状评分、外侧覆盖角、α角、年龄、性别和关节病的放射学分类相关联。P值<0.05的结果被认为具有统计学意义。 髋关节有深层损伤的患者的非关节炎髋关节评分（NAHSs）显著高于髋关节有轻度损伤或无软骨损伤的患者（67.9±19.4对57.0±21.9，P = 0.027）。与Tonnis 0级的髋关节相比，Tonnis 1级的髋关节深层损伤患病率更高：分别为15例（55.6%）对10例（12.7%），P<0.001。男性III级和IV级损伤的患病率高于女性，分别为23例（34.3%）对2例（5.0%），P = 0.001，且男性的功能评分显著更高（65.6±19.6对49.3±21.6，P<0.001）。 男性深层损伤的患病率更高。分类为Tonnis 1级的髋关节出现这些损伤的可能性高4.4倍。有深层软骨唇损伤的患者术前功能评分更好。
