Department of Orthopedics, Barzilai Medical Center, Ashkelon, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Arthroscopy. 2020 Jan;36(1):159-164. doi: 10.1016/j.arthro.2019.08.012.
To evaluate the effects of immediate postoperative weightbearing protocols after hip arthroscopy for femoroacetabular impingement (FAI) with minimum 2-year follow-up, as measured by patient-reported outcome measures and satisfaction rates.
Between January 2011 and June 2016, patients undergoing hip arthroscopy for FAI and labral tears were reviewed. Exclusion criteria was previous hip pathology or arthroscopy, active Workers' Compensation claims, and concomitant pathologies impeding weightbearing. Patients who were operated on before September 2013 were treated with 3 weeks of postoperative non-weightbearing (NWB), with weightbearing as tolerated (WBAT) thereafter. From October 2013, patients were allowed immediate postoperative WBAT.
A total of 351 hip arthroscopic surgeries were performed; 133 of these patients met the inclusion criteria. Of the 133 included patients, 69 were in the NWB group and 64 were in the WBAT group. No differences were found in terms of sex (P = .603) or age (P = .241). No differences were found in postoperative scores (the Modified Harris Hip Score was 84.5 [range 79-89] for NWB vs 86.7 [78-89] for WBAT [P = .0.523], and the Hip Outcome Score was 83.1 [78-88] vs 88.4 [80-90], respectively; P = .130). Subjective rates of improvement, satisfaction score and the will to undergo surgery again did not differ between the groups (P = .674, P = .882, P = .730). The rate of subjects who met or exceeded the MCID in the NWB and WBAT groups was 82.6% and 81.2% for the Modified Harris Hip Score (P = .838) and 79.7% and 82.8% for the Hip Outcome Score (P = .647). There were no reported complications. Limitations include the possibility of the study being underpowered.
After a 2-year minimum follow-up, patient-reported outcome measures and satisfactory rates with immediate weightbearing after hip arthroscopy for isolated FAI syndrome and labral tears do not differ significantly from results after strict NWB rehabilitation protocols. Revising weightbearing restrictions may allow for a more comfortable rehabilitation process after arthroscopic hip surgery for FAI and labral repair.
Level 3 - case-control study.
通过患者报告的结果测量和满意度评分，评估髋关节镜检查治疗股骨髋臼撞击症（FAI）后即刻负重方案的效果，随访时间至少为 2 年。
回顾 2011 年 1 月至 2016 年 6 月期间接受髋关节镜检查治疗 FAI 和盂唇撕裂的患者。排除标准为既往髋关节疾病或关节镜检查、正在进行的工人赔偿索赔以及妨碍负重的并存疾病。2013 年 9 月前接受手术的患者接受 3 周的术后非负重（NWB）治疗，此后允许耐受负重（WBAT）。从 2013 年 10 月开始，允许患者术后即刻负重。
共进行了 351 例髋关节镜手术，其中 133 例符合纳入标准。在纳入的 133 例患者中，69 例为 NWB 组，64 例为 WBAT 组。两组在性别（P=0.603）或年龄（P=0.241）方面无差异。术后评分也无差异（改良 Harris 髋关节评分 NWB 组为 84.5（79-89），WBAT 组为 86.7（78-89）；P=0.523），髋关节结果评分 NWB 组为 83.1（78-88），WBAT 组为 88.4（80-90）；P=0.130）。两组之间的主观改善率、满意度评分和再次手术意愿无差异（P=0.674，P=0.882，P=0.730）。在改良 Harris 髋关节评分中，NWB 和 WBAT 组分别有 82.6%和 81.2%的患者达到或超过 MCID（P=0.838），在髋关节结果评分中，分别有 79.7%和 82.8%的患者达到或超过 MCID（P=0.647）。没有报告并发症。局限性包括研究可能没有足够的效力。
至少 2 年的随访结果表明，与严格的 NWB 康复方案相比，髋关节镜检查治疗孤立性 FAI 综合征和盂唇撕裂后即刻负重的患者报告的结果测量和满意度评分无显著差异。修改负重限制可能会使 FAI 和盂唇修复后的髋关节镜手术后的康复过程更加舒适。
3 级-病例对照研究。
