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关节镜检查在创伤后髋关节疼痛诊断和治疗中的作用:一项前瞻性研究

Role of arthroscopy for the diagnosis and management of post-traumatic hip pain: a prospective study.

作者信息

Alfikey Arafat, El-Bakoury Ahmed, Karim Mahmoud Abdel, Farouk Hazem, Kaddah Mohamed Abdelhalem, Abdelazeem Ahmed Hazem

机构信息

Orthopaedic Department, Khoula Hospital, Mina alfahl, P.O. Box: 90, P.C: 116, Muscat, Oman.

Orthopaedic Department, University of Calgary, Calgary, Canada.

出版信息

J Hip Preserv Surg. 2019 Nov 18;6(4):377-384. doi: 10.1093/jhps/hnz052. eCollection 2019 Dec.


DOI:10.1093/jhps/hnz052
PMID:32015890
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6990388/
Abstract

The current published literature regarding the role of hip arthroscopy in the diagnosis and management of post-traumatic hip pain is still limited. Therefore, we conducted the present prospective study to determine the value of hip arthroscopy in the diagnosis and management of various causes of hip pain after traumatic conditions. The present study included a prospective cohort of 17 patients with symptomatic post-traumatic hip pain. It was conducted between July 2013 and May 2018. The mean age was 22 (19-29) years and the mean follow-up was 24 (: 7-36) months. Prior to surgery, every eligible patient underwent assessment of functional status using the Modified Harris Hip Score, Oxford hip score (OHS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. All patients underwent arthroscopic management for their diagnosed pathologies. The most commonly encountered diagnosis was labral tear (58.8%), followed by ligamentum teres tear (35.3%) and loose intra-articular fragments (29.4%). In addition, 52.9% of the patients had associated CAM lesion and 11.8% had associated Pincer lesion. The mHSS, OHS and WOMAC score showed significant improvement in the post-operative period ( < 0.001), all the 17 patients had 100% Patient Acceptable Symptomatic State; only one patient did not achieve minimal clinical importance difference. One case underwent labral debridement for failed labral repair (5.8%), another patient developed maralgia paraesthetica (5.8%). In conclusion, hip arthroscopy is a useful and effective minimally invasive procedure for the diagnosis and management of selected patients with post-traumatic hip pain. Moreover, hip arthroscopy was safe technique with no reported serious adverse events.

摘要

目前已发表的关于髋关节镜检查在创伤后髋关节疼痛诊断和治疗中作用的文献仍然有限。因此,我们开展了本前瞻性研究,以确定髋关节镜检查在创伤后各种原因引起的髋关节疼痛诊断和治疗中的价值。本研究纳入了17例有症状的创伤后髋关节疼痛患者的前瞻性队列。研究于2013年7月至2018年5月进行。平均年龄为22(19 - 29)岁,平均随访时间为24(7 - 36)个月。手术前,每位符合条件的患者使用改良Harris髋关节评分、牛津髋关节评分(OHS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分进行功能状态评估。所有患者均接受了针对其诊断出的病变的关节镜治疗。最常见的诊断是盂唇撕裂(58.8%),其次是圆韧带撕裂(35.3%)和关节内游离碎片(29.4%)。此外,52.9%的患者伴有凸轮病变,11.8%的患者伴有钳夹病变。改良Harris髋关节评分、牛津髋关节评分和WOMAC评分在术后均有显著改善(<0.001),所有17例患者均达到100%患者可接受症状状态;只有1例患者未达到最小临床重要差异。1例因盂唇修复失败接受了盂唇清创术(5.8%),另1例患者出现感觉异常性股痛(5.8%)。总之,髋关节镜检查对于创伤后髋关节疼痛的特定患者的诊断和治疗是一种有用且有效的微创手术。此外,髋关节镜检查是一种安全的技术,未报告严重不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/10084653f94c/hnz052f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/d6ebf325d759/hnz052f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/7ba267a92266/hnz052f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/554d9461925e/hnz052f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/10084653f94c/hnz052f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/d6ebf325d759/hnz052f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/7ba267a92266/hnz052f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/554d9461925e/hnz052f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1065/6990388/10084653f94c/hnz052f4.jpg

相似文献

[1]
Role of arthroscopy for the diagnosis and management of post-traumatic hip pain: a prospective study.

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[2]
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[3]
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[4]
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[6]
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[9]
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[10]
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引用本文的文献

[1]
Pipkin type III fractures: a narrative review of literature and comparative opinion on ORIF vs. arthroplasty.

Front Surg. 2025-8-18

[2]
Arthroscopic Reduction and Fixation of a Pipkin Type-I Femoral Head Fracture.

JBJS Essent Surg Tech. 2024-5-21

[3]
Comparison of dorsal and medial arthroscopic approach to canine coxofemoral joint: a cadaveric study.

J Vet Sci. 2023-1

[4]
Arthroscopy-Assisted Reduction and Fixation of Femoral Head and Acetabulum Fractures: A Systematic Review of the Literature.

Orthop Surg. 2022-4

本文引用的文献

[1]
Arthroscopy After Traumatic Hip Dislocation: A Systematic Review of Intra-articular Findings, Correlation With Magnetic Resonance Imaging and Computed Tomography, Treatments, and Outcomes.

Arthroscopy. 2017-11-13

[2]
Arthroscopic Labral Base Repair in the Hip: 5-Year Minimum Clinical Outcomes.

Am J Sports Med. 2017-10

[3]
Arthroscopic Reduction and Internal Fixation for Pipkin Type I Femoral Head Fracture: Technical Note.

Arthrosc Tech. 2016-9-5

[4]
Incidence of symptomatic femoroacetabular impingement in the general population: a prospective registration study.

J Hip Preserv Surg. 2016-3-25

[5]
Clinically Meaningful Improvements After Hip Arthroscopy for Femoroacetabular Impingement in Adolescent and Young Adult Patients Regardless of Gender.

J Pediatr Orthop. 2018-10

[6]
Management of Hip Pain in Young Adults.

Orthop Clin North Am. 2016-7

[7]
Arthroscopic and imaging findings after traumatic hip dislocation in patients younger than 25 years of age.

J Hip Preserv Surg. 2015-5-29

[8]
Arthroscopic Treatment of Traumatic Hip Dislocation.

J Am Acad Orthop Surg. 2016-5

[9]
Usefulness of Arthroscopic Treatment of Painful Hip after Acetabular Fracture or Hip Dislocation.

Clin Orthop Surg. 2015-12

[10]
The Patient Acceptable Symptomatic State for the Modified Harris Hip Score and Hip Outcome Score Among Patients Undergoing Surgical Treatment for Femoroacetabular Impingement.

Am J Sports Med. 2015-8

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