Department of Orthopaedic Surgery, Inje University College of Medicine and Inje University Haeundae Paik Hospital, Busan, Republic of Korea.
Department of Orthopaedic Surgery, Chung-Ang University College of Medicine and Chung-Ang University Hospital, Seoul, Republic of Korea.
Am J Sports Med. 2020 Apr;48(5):1168-1174. doi: 10.1177/0363546520907106. Epub 2020 Mar 9.
Recently, a hypertrophic labrum has been reported in the absence of hip dysplasia, which can possibly contribute to an acetabular labral tear.
To compare the clinical outcomes and complications, including the incidence of iatrogenic acetabular labrum and cartilage injury, in patients with tears of hypertrophic versus morphologically normal acetabular labra over a minimum follow-up period of 2 years and to assess the morphologic changes at follow-up computed tomography arthrography in the 2 groups.
Cohort study; Level of evidence, 3.
Between January 2010 and December 2016, 20 patients (22 hips) with a hypertrophic labrum underwent arthroscopic hip surgery. A total of 22 patients (22 hips) without a hypertrophic labrum were assigned to the control group based on matching criteria, including age, sex, body mass index, labral tear, and labral repair. Clinical outcomes were assessed with the visual analog scale score, UCLA activity scale score (University of California, Los Angeles), and modified Harris Hip Score. Radiologic outcomes were assessed through serial radiography. Patients were followed for at least 2 years.
The mean age at surgery was 42 years. The most common cause of arthroscopic surgery in the study group was an isolated acetabular labral tear without any bony structural abnormalities (68.2%, 15 of 22 hips). All improvements in both groups were statistically significant at the last postoperative follow-up ( < .001). Although the radiologic and clinical outcomes were not significantly different between the groups, the complication rates, including iatrogenic labral perforations and cartilage injury, were significantly higher in patients with hypertrophic acetabular labral tears (9 vs 3, = .042). The patient-reported satisfaction scores at the last postoperative follow-up were 8.4 and 7.9 in the study and control groups, respectively ( = .351).
The high rates of patient-reported satisfaction and the clinical outcomes after arthroscopic repair in both groups are encouraging. Arthroscopic treatment in patients with hypertrophic acetabular labral tears should be carefully performed to prevent iatrogenic injury during the surgery, and isolated hypertrophic labral tears can have good results after repair.
最近，在没有髋关节发育不良的情况下，出现了肥厚的盂唇，这可能导致髋臼盂唇撕裂。
比较肥厚型与形态正常型髋臼盂唇撕裂患者的临床结果和并发症，包括医源性髋臼盂唇和软骨损伤的发生率，在至少 2 年的随访期内，并评估两组在随访时的 CT 关节造影的形态变化。
队列研究；证据水平，3 级。
2010 年 1 月至 2016 年 12 月，20 例（22 髋）患者行关节镜髋关节手术，其中 22 例（22 髋）无肥厚盂唇患者根据年龄、性别、体重指数、盂唇撕裂和盂唇修复等匹配标准纳入对照组。采用视觉模拟评分法（VAS）、加利福尼亚大学洛杉矶分校（UCLA）活动量表评分（University of California, Los Angeles）和改良 Harris 髋关节评分评估临床结果。通过连续 X 线摄影评估放射学结果。患者至少随访 2 年。
手术时的平均年龄为 42 岁。研究组最常见的关节镜手术原因是孤立性髋臼盂唇撕裂，无任何骨结构异常（68.2%，22 髋中有 15 髋）。两组在最后一次术后随访时的所有改善均具有统计学意义（<.001）。尽管两组的影像学和临床结果无显著差异，但肥厚型髋臼盂唇撕裂患者的并发症发生率，包括医源性盂唇穿孔和软骨损伤，明显较高（9 例比 3 例，=.042）。最后一次术后随访时，患者报告的满意度评分分别为研究组和对照组的 8.4 分和 7.9 分（=.351）。
两组患者报告的满意度和关节镜修复后的临床结果均较高，令人鼓舞。关节镜治疗肥厚型髋臼盂唇撕裂时应谨慎操作，以防止手术中的医源性损伤，单纯性肥厚型盂唇撕裂在修复后可获得良好的效果。
