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分期双侧髋关节镜与匹配的单侧髋关节镜组比较:至少 2 年随访。

Staged Bilateral Hip Arthroscopy Compared With a Matched Unilateral Hip Arthroscopy Group: Minimum 2-Year Follow-Up.

机构信息

NYU Langone Orthopedics, New York, York, U.S.A.

NYU Langone Orthopedics, New York, York, U.S.A..

出版信息

Arthroscopy. 2020 Jul;36(7):1856-1861. doi: 10.1016/j.arthro.2020.02.025. Epub 2020 Feb 28.

Abstract

PURPOSE

To determine the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) at 2-year follow up in patients who underwent staged bilateral hip arthroscopy versus age-, sex-, and body mass index-matched patients who underwent unilateral hip arthroscopy.

METHODS

Patients who underwent staged bilateral primary hip arthroscopy between January 2007 and December 2017 for the indication of femoroacetabular impingement (FAI) with a minimum 2-year follow-up were identified. The control group comprised patients who underwent a unilateral hip arthroscopy for FAI. The mHHS and the NAHS were analyzed.

RESULTS

Forty-two patients (84 hips) in the bilateral group were matched with 84 patients (84 hips) in the unilateral group. Both groups had significantly improved mHHS and NAHS when comparing preoperative scores with postoperative scores (bilateral group mHHS: 45.5 ± 15.1 to 81.7 ± 17.6, P < .0001, bilateral group NAHS: 49.5 ± 13.8 to 83.6 ± 20.0, P < .0001, unilateral group mHHS 48.5 ± 13.8 to 83.6 ± 15.9, P < .0001, unilateral group NAHS 48.8 ± 12.0 to 85.0 ± 16.6, P < .0001). The patient-acceptable symptomatic state was achieved in 57 hips (68%) in the bilateral group versus 62 hips (74%) in the unilateral group, P = .4. Patients with bilateral hip arthroscopy who had <17 months between index procedure and contralateral hip arthroscopy had significantly better mHHS and NAHS (85.5 ± 18.4 vs 75.71 ± 14.4, P = .013 for mHHS and 88.1 ± 17.1 vs 76.2 ± 22.4, P = .0074 for NAHS).

CONCLUSIONS

Bilateral hip arthroscopy for the indication of FAI has improved mHHS and NAHS at 2 years of follow up compared to baseline. There was no difference in 2-year mHHS and NAHS in patients who underwent bilateral hip arthroscopy and unilateral hip arthroscopy. Patients in the bilateral hip arthroscopy group that had the contralateral surgery longer than 17 months from index procedure had lower 2 year follow up mHHS and NAHS scores than those that underwent the second surgery within 17 months of the index procedure.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

摘要

目的

比较分期双侧髋关节镜与同期单侧髋关节镜治疗髋关节撞击综合征患者 2 年随访时改良 Harris 髋关节评分(mHHS)和非关节炎髋关节评分(NAHS)。

方法

回顾性分析 2007 年 1 月至 2017 年 12 月因髋关节撞击综合征行分期双侧初次髋关节镜手术且随访时间至少 2 年的患者。对照组为同期行单侧髋关节镜手术治疗髋关节撞击综合征的患者。分析 mHHS 和 NAHS。

结果

双侧组 84 髋与单侧组 84 髋匹配。两组术前 mHHS 和 NAHS 评分均低于术后评分(双侧组 mHHS:45.5±15.1 至 81.7±17.6,P<.0001,双侧组 NAHS:49.5±13.8 至 83.6±20.0,P<.0001,单侧组 mHHS 48.5±13.8 至 83.6±15.9,P<.0001,单侧组 NAHS 48.8±12.0 至 85.0±16.6,P<.0001)。双侧组 57 髋(68%)达到患者可接受的症状缓解状态,单侧组 62 髋(74%)达到患者可接受的症状缓解状态,P=0.4。双侧髋关节镜手术患者,从初次手术到对侧手术的间隔时间<17 个月,mHHS 和 NAHS 评分显著更好(mHHS:85.5±18.4 与 75.71±14.4,P=0.013;NAHS:88.1±17.1 与 76.2±22.4,P=0.0074)。

结论

与基线相比,髋关节撞击综合征行分期双侧髋关节镜手术治疗可改善 mHHS 和 NAHS,双侧髋关节镜手术与单侧髋关节镜手术患者 2 年 mHHS 和 NAHS 评分无差异。双侧髋关节镜手术患者,如果初次手术后 17 个月以上才进行对侧手术,其 2 年随访时的 mHHS 和 NAHS 评分会低于初次手术后 17 个月内进行对侧手术的患者。

证据等级

III 级,回顾性比较研究。

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