Department of Orthopedic Surgery, Mayo Clinic in Arizona, Phoenix, Arizona, U.S.A.
American Hip Institute, Chicago, Illinois, U.S.A.
Arthroscopy. 2020 Aug;36(8):2147-2157. doi: 10.1016/j.arthro.2020.04.022. Epub 2020 Apr 27.
To assess whether labral size is predictive of labral repair failure or shows an association with patient outcomes after hip arthroscopy.
We performed a retrospective chart review of patients who underwent arthroscopic hip labral repair. Labral size was measured in 4 quadrants with an arthroscopic probe. The average size across torn labral segments was assessed for failure as determined by the change in patient-reported outcomes, the rate at which subjects achieved the minimal clinically important difference and patient acceptable symptomatic state, and the need for additional surgery. Outcomes were evaluated for any continuous correlation as well as significant differences between the middle 50% of labral sizes and classes of labral sizes derived from upper and lower quartile and decile ranges. Included hips were those from patients aged between 18 and 55 years with 2-year postoperative follow-up and lateral center-edge angles between 25° and 40°.
The study included 571 hips. Labral width did not show a significant difference between hips requiring revision and those not requiring revision (P = .4054). No significant correlation was found between labral width and the change in the International Hip Outcome Tool 12 score (R = 0.05780), modified Harris Hip Score (R = 0.19826), or Nonarthritic Hip Score (R = 0.23543) from preoperatively to 2 years postoperatively. Hips with labral sizes in the upper decile of our cohort showed significantly decreased improvement in the International Hip Outcome Tool 12 score (P = .0287) and Nonarthritic Hip Score (P = .0490) compared with the middle 50% of labral sizes. No statistically significant difference was found in the rate at which the groups achieved the minimal clinically important difference or patient acceptable symptomatic state.
Hypertrophic labra in the largest 10th percentile showed lower postoperative outcome scores. However, no detectable clinical benefit was found in terms of patient-perceived clinical difference or acceptable symptomatic state. For most patients, labral size does not appear to significantly alter patient outcomes or the need for arthroplasty.
Level IV, retrospective case series.
评估盂唇大小是否可预测盂唇修复失败，或与髋关节镜检查后的患者结局相关。
我们对接受关节镜下髋关节盂唇修复的患者进行了回顾性图表审查。使用关节镜探针在 4 个象限测量盂唇大小。评估撕裂盂唇段的平均大小，以确定患者报告的结果变化、患者达到最小临床重要差异和可接受的症状状态的比例以及是否需要进一步手术。评估了任何连续相关性以及中间 50%的盂唇大小与来源于上四分位数和十分位数范围的盂唇大小类别之间的显著差异。纳入的髋关节为年龄在 18 至 55 岁之间、术后 2 年随访且外侧中心边缘角在 25°至 40°之间的患者。
该研究共纳入 571 髋。需要翻修的髋关节与不需要翻修的髋关节的盂唇宽度无显著差异（P=0.4054）。盂唇宽度与国际髋关节结果工具 12 评分（R=0.05780）、改良 Harris 髋关节评分（R=0.19826）或非关节炎髋关节评分（R=0.23543）从术前到术后 2 年的变化之间无显著相关性。与中间 50%的盂唇大小相比，我们队列中盂唇大小处于上十分位数的髋关节的国际髋关节结果工具 12 评分（P=0.0287）和非关节炎髋关节评分（P=0.0490）显著改善降低。两组患者达到最小临床重要差异或可接受的症状状态的比例无统计学显著差异。
最大 10%的肥大盂唇显示术后结局评分较低。然而，在患者感知的临床差异或可接受的症状状态方面，没有发现明显的临床获益。对于大多数患者而言，盂唇大小似乎不会显著改变患者结局或需要进行关节置换。
IV 级，回顾性病例系列。
