Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Orthopaedic Surgery, Hyogo Rehabilitation Center Hospital, Kobe, Japan.
Eur J Orthop Surg Traumatol. 2020 May;30(4):737-742. doi: 10.1007/s00590-020-02627-0. Epub 2020 Jan 20.
This study investigated whether the preoperative response to intra-articular injections is associated with intra-articular pathological findings and arthroscopy outcomes.
This study included 49 patients who underwent arthroscopic hip surgery for femoroacetabular impingement and labral tear after receiving preoperative hip joint injections. The response to anaesthetic injections was categorized as poor (0-50%) or good (51-100%). With respect to anatomical indices, we evaluated the lateral centre-edge angle (LCEA), acetabular roof obliquity (ARO), vertical-centre-anterior angle (VCA), and the alpha angle (on a lateral view). We evaluated the association between these indices (including the types of hip labral tears and cartilage damage) and the effectiveness of intra-articular injections.
The study included 22 men and 27 women, and the mean age of patients was 36.4 years. No statistically significant association was observed between the response to preoperative anaesthetic hip joint injections and patient demographics (age, sex) and anatomical indices (LCEA, ARO, VCA, and alpha angle) (p > 0.05). All patients showed labral damage; however, labral tear classification or cartilage damage was not significantly associated with the effectiveness of joint injections. At the 1-year post-operative follow-up, patients with a good response to anaesthetic hip joint injections showed a significantly better outcome than patients with a poor response to these injections (p < 0.01).
The response to preoperative anaesthetic hip joint injections may indicate the presence of intra-articular pathology. Furthermore, this association may have predictive value in determining post-operative outcomes following hip arthroscopy.
本研究旨在探讨关节内注射的术前反应是否与关节内病理发现和关节镜结果相关。
本研究纳入了 49 例因股骨髋臼撞击症和盂唇撕裂而接受髋关节镜手术的患者，这些患者在接受髋关节术前注射前被分为麻醉注射反应差（0-50%）或反应好（51-100%）。在解剖学指标方面，我们评估了外侧中心边缘角（LCEA）、髋臼顶倾斜角（ARO）、垂直中心前角（VCA）和阿尔法角（侧位片）。我们评估了这些指标（包括髋关节盂唇撕裂和软骨损伤的类型）与关节内注射效果之间的关系。
研究纳入了 22 名男性和 27 名女性，患者的平均年龄为 36.4 岁。术前麻醉髋关节注射的反应与患者的人口统计学特征（年龄、性别）和解剖学指标（LCEA、ARO、VCA 和阿尔法角）之间没有统计学显著关联（p>0.05）。所有患者均存在盂唇损伤，但盂唇撕裂分类或软骨损伤与关节注射效果无显著相关性。在术后 1 年随访时，对麻醉髋关节注射反应良好的患者的结果明显优于反应差的患者（p<0.01）。
术前麻醉髋关节注射的反应可能提示关节内存在病理。此外，这种关联可能对预测髋关节镜术后的结果具有价值。
