The Orthopaedic Clinic Association, Phoenix, Arizona, USA.
Department of Orthopaedics, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Am J Sports Med. 2020 Mar;48(3):654-660. doi: 10.1177/0363546519895259. Epub 2020 Jan 13.
Hip arthroscopy is a safe and effective mechanism for treating femoroacetabular impingement symptoms in high level athletes. Bilateral symptoms occur in a subset of this population.
To discuss outcomes of bilateral hip arthroscopy in high-level athletes and compare a standard staged timeline for bilateral hip arthroscopic surgery versus an accelerated timeline.
Cohort study; Level of evidence, 3.
A retrospective review of all staged bilateral hip arthroscopies was performed on high-level athletes over a 3-year period. Patients were categorized into cohorts based upon when the second procedure was performed (4-6 weeks after the index procedure or >6 weeks after the index procedure). Exclusion criteria included any prior hip surgery, advanced arthritis, previous pelvic or femoral fracture, or inflammatory arthropathy. Demographics, radiographic measurements, operative reports of procedures performed, and patient-reported outcomes (Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sport Specific Subscale, modified Harris Hip Score, return to sports, return to same level of play) were compared between groups at 6-month, 1-year, and 2-year intervals, with the Student test used for continuous data and a chi-square test used for categorical data.
50 patients were identified: 22 in the accelerated surgery (AS) group and 28 in the standard surgery (SS) group. Age and number of collegiate participants were greater in the AS group, whereas the number of high school participants and the time away from sports were higher in the SS group. Preoperative alpha angles were significantly larger among the AS group, but no differences were found in postoperative alpha angles, center edge angles, or Tönnis grades. No significant difference was seen in patient-reported outcomes between the 2 groups at 6-month, 1-year, and 2-year follow-up.
Bilateral hip arthroscopy performed 4 to 6 weeks apart is a safe and effective treatment option for athletes with bilateral femoroacetabular impingement and labral tears; the procedures entail a high rate of return to sports, return to the same level of sports, and decreased time lost from sports. This information could be useful for an athlete deciding on whether to proceed with bilateral hip arthroscopy and deciding on the timing for the procedures.
髋关节镜检查是治疗高水平运动员髋关节撞击综合征的一种安全有效的方法。该人群中存在亚组双侧症状。
讨论双侧髋关节镜检查在高水平运动员中的结果，并比较双侧髋关节镜手术的标准分期时间与加速时间。
队列研究；证据水平，3 级。
对过去 3 年中进行分期双侧髋关节镜检查的高水平运动员进行回顾性研究。根据第二次手术的时间（索引手术后 4-6 周或索引手术后>6 周）将患者分为两组。排除标准包括任何先前的髋关节手术、晚期关节炎、先前的骨盆或股骨骨折或炎症性关节炎。比较两组患者的一般资料、影像学测量、手术报告和患者报告的结果（髋关节结果评分-日常活动、髋关节结果评分-专项活动评分、改良 Harris 髋关节评分、重返运动、重返相同运动水平），比较两组患者在 6 个月、1 年和 2 年随访时的差异，采用学生 t 检验进行连续数据比较，卡方检验进行分类数据比较。
共确定 50 名患者：加速手术（AS）组 22 例，标准手术（SS）组 28 例。AS 组年龄和大学参与者人数较多，而 SS 组高中参与者人数和运动停训时间较长。AS 组术前 alpha 角明显较大，但术后 alpha 角、中心边缘角和 Tönnis 分级无差异。两组患者在 6 个月、1 年和 2 年随访时的患者报告结果无显著差异。
对于双侧髋关节撞击综合征和盂唇撕裂的运动员，4-6 周间隔进行双侧髋关节镜检查是一种安全有效的治疗选择；该手术有较高的重返运动、重返相同运动水平和减少运动停训时间的比例。这些信息可能对运动员决定是否进行双侧髋关节镜检查以及决定手术时间有用。
