Maldonado David R, Chen Sarah L, Yelton Mitchell J, Rosinsky Philip J, Walker-Santiago Rafael, Shapira Jacob, Lall Ajay C, Domb Benjamin G
American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA.
Orthop J Sports Med. 2020 Feb 5;8(2):2325967119900767. doi: 10.1177/2325967119900767. eCollection 2020 Feb.
Labral reconstruction has been advocated as an alternative to debridement for the treatment of irreparable labral tears, showing favorable short-term results. However, literature is scarce regarding outcomes and return to sport in the nonelite athletic population.
To report minimum 1-year clinical outcomes and the rate of return to sport in athletic patients who underwent primary hip arthroscopy with labral reconstruction in the setting of femoroacetabular impingement syndrome and irreparable labral tears.
Case series; Level of evidence, 4.
Data were prospectively collected and retrospectively analyzed for patients who underwent an arthroscopic labral reconstruction between August 2012 and December 2017. Patients were included if they identified as an athlete (high school, college, recreational, or amateur); had follow-up on the following patient-reported outcomes (PROs): modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS); and completed a return-to-sport survey at 1 year postoperatively. Patients were excluded if they underwent any previous ipsilateral hip surgery, had dysplasia, or had prior hip conditions. The proportions of patients who achieved the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for mHHS and HOS-SSS were calculated. Statistical significance was set at = .05.
There were 32 (14 females) athletes who underwent primary arthroscopic labral reconstruction during the study period. The mean age and body mass index of the group were 40.3 years (range, 15.5-58.7 years) and 27.9 kg/m (range, 19.6-40.1 kg/m), respectively. The mean follow-up was 26.4 months (range, 12-64.2 months). All patients demonstrated significant improvement in mHHS, NAHS, HOS-SSS, and VAS ( < .001) at latest follow-up. Additionally, 84.4% achieved MCID and 81.3% achieved PASS for mHHS, and 87.5% achieved MCID and 75% achieved PASS for HOS-SSS. VAS pain scores decreased from 4.4 to 1.8, and the satisfaction with surgery was 7.9 out of 10. The rate of return to sport was 78%.
At minimum 1-year follow-up, primary arthroscopic labral reconstruction, in the setting of femoroacetabular impingement syndrome and irreparable labral tears, was associated with significant improvement in PROs in athletic populations. Return to sport within 1 year of surgery was 78%.
对于无法修复的盂唇撕裂,盂唇重建已被提倡作为清创术的替代方法,短期效果良好。然而,关于非精英运动员人群的治疗结果和恢复运动情况的文献较少。
报告在股骨髋臼撞击综合征和无法修复的盂唇撕裂情况下接受初次髋关节镜下盂唇重建的运动员患者至少1年的临床结果和恢复运动率。
病例系列;证据等级,4级。
前瞻性收集并回顾性分析2012年8月至2017年12月期间接受关节镜下盂唇重建的患者数据。纳入标准为:自认为是运动员(高中、大学、休闲或业余运动员);有以下患者报告结局(PROs)的随访数据:改良Harris髋关节评分(mHHS)、非关节炎髋关节评分(NAHS)、髋关节结局评分-运动特定子量表(HOS-SSS)和视觉模拟量表(VAS);并在术后1年完成恢复运动调查。排除标准为:既往同侧髋关节曾接受过任何手术、有髋关节发育不良或既往有髋关节疾病。计算达到mHHS和HOS-SSS最小临床重要差异(MCID)及患者可接受症状状态(PASS)的患者比例。设定统计学显著性水平为α = 0.05。
在研究期间,有32名(14名女性)运动员接受了初次关节镜下盂唇重建。该组患者的平均年龄和体重指数分别为40.3岁(范围15.5 - 58.7岁)和27.9 kg/m²(范围19.6 - 40.1 kg/m²)。平均随访时间为26.4个月(范围12 - 64.2个月)。所有患者在最近一次随访时mHHS、NAHS、HOS-SSS和VAS均有显著改善(P < 0.001)。此外对于mHHS,84.4%的患者达到MCID,81.3%的患者达到PASS;对于HOS-SSS,87.5%的患者达到MCID,75%的患者达到PASS。VAS疼痛评分从4.4降至1.8,手术满意度为十分制中的7.9分。恢复运动率为78%。
在至少1年的随访中,在股骨髋臼撞击综合征和无法修复的盂唇撕裂情况下进行的初次关节镜下盂唇重建与运动员人群的PROs显著改善相关。术后1年内恢复运动率为78%。