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社论评论:对短期结局的荟萃分析的评论。

Editorial Commentary: A Commentary on a Meta-analysis of Short-Term Outcomes.

机构信息

La Trobe University.

出版信息

Arthroscopy. 2020 Jan;36(1):274-276. doi: 10.1016/j.arthro.2019.09.035.

Abstract

Hip pain is prevalent and costly, and young patients with hip femoroacetabular impingement have similar levels of pain and quality of life to older patients with hip osteoarthritis. Hip arthroscopic surgery for femoroacetabular impingement is increasing in prevalence, and the benefits of operative treatment compared with nonoperative treatment require consideration. Hip arthroscopy should not be a first-line treatment but can be necessary in cases in which high-quality, exercise-based nonsurgical treatment options have been exhausted. Patients should be informed that surgery is not necessarily cost-effective and may have an increased risk of comorbidities such as chronic pain and insomnia. Patient-reported outcomes may improve by up to 20% with either surgery or physical therapy but are not likely to return to those seen in patients without hip pain. Although most patients return to sport after hip arthroscopy, the ability to participate at a preinjury level is seen in fewer than a quarter of patients. Return-to-sport rates with physiotherapist-led nonoperative treatment are not known.

摘要

髋关节疼痛普遍且代价高昂,患有髋关节股骨髋臼撞击症的年轻患者与患有髋关节骨关节炎的老年患者具有相似的疼痛程度和生活质量。髋关节镜手术治疗股骨髋臼撞击症的发病率正在上升,与非手术治疗相比,手术治疗的益处需要考虑。髋关节镜检查不应该是一线治疗方法,但在高质量、基于运动的非手术治疗方法已经用尽的情况下可能是必要的。应该告知患者,手术不一定具有成本效益,并且可能会增加慢性疼痛和失眠等合并症的风险。手术或物理治疗可使患者的报告结果提高多达 20%,但不太可能恢复到无髋关节疼痛患者的水平。尽管大多数患者在髋关节镜手术后都能恢复运动,但只有不到四分之一的患者能够恢复到受伤前的运动水平。尚不清楚物理治疗师主导的非手术治疗的重返运动率。

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