Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark.
Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Hvidovre, Denmark.
J Bone Joint Surg Am. 2020 Nov 4;102(Suppl 2):43-50. doi: 10.2106/JBJS.19.01496.
The Danish Hip Arthroscopy Registry (DHAR) started as a web-based prospective registry in 2012. The aim of this study was to evaluate and report epidemiologic and perioperative data from 5,333 procedures and to describe the development of the DHAR.
The DHAR collects data from patients prospectively at the time of inclusion (preoperative evaluation) and at 1, 2, 5, and 10 years after arthroscopic hip surgery. The surgeon reports surgical data at the time of surgery. The DHAR uses a number of validated patient-related outcome measures (PROMs): the Copenhagen Hip and Groin Outcome Score (HAGOS), Hip Sports Activity Scale (HSAS), EuroQol 5 Dimensions (EQ-5D), and a numeric rating scale for pain (NRS pain).
Of the 5,333 procedures, 58% were done in female patients. The mean age was 37.7 years. The mean duration of surgery was 78 minutes, and the mean duration of traction was 45 minutes. Combined cam and pincer resections were performed in 64% of the patients, and labral repair was done in 82%. The most common type of acetabular chondral damage found was Beck grade-2 lesions (43%). Grade-3 and 4 changes were seen in 29% and 11% of the patients, respectively. The 1-year HAGOS PROM values increased to a median of 69.1 (interquartile range [IQR], 68.2 to 70.0) for pain, 64.9 (IQR, 64.0 to 65.7) for symptoms, 71.3 (IQR, 70.3 to 72.3) for activities of daily living, 56.2 (IQR, 55.1 to 57.4) for sports, 42.2 (IQR, 40.8 to 43.5) for physical activity, and 50.7 (IQR, 49.7 to 51.8) for quality of life, and the 1-year EQ-5D increased to a median of 0.75 (IQR, 0.74 to 0.76). Five-year outcomes for 383 patients showed a significant increase in all PROMs (p < 0.05).
Patients referred for hip arthroscopy reported pain, functional disabilities, and a decreased activity level and quality of life prior to surgery but demonstrated improvements after 1 and 5 years. The problems with developing and maintaining a large clinical registry are described. The development of a national clinical registry for hip arthroscopy was considered successful.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
丹麦髋关节镜检查注册中心（DHAR）于 2012 年开始作为一个基于网络的前瞻性注册中心。本研究的目的是评估和报告 5333 例手术的流行病学和围手术期数据，并描述 DHAR 的发展情况。
DHAR 在患者纳入时（术前评估）和关节镜髋关节手术后 1、2、5 和 10 年时前瞻性地收集患者数据。外科医生在手术时报告手术数据。DHAR 使用了多种经过验证的患者相关结局测量指标（PROMs）：哥本哈根髋关节和腹股沟结局评分（HAGOS）、髋关节运动活动量表（HSAS）、欧洲五维健康量表（EQ-5D）和疼痛数字评分量表（NRS 疼痛）。
在 5333 例手术中，58%为女性患者。平均年龄为 37.7 岁。手术平均持续时间为 78 分钟，牵引平均持续时间为 45 分钟。64%的患者接受了联合凸轮和钳夹切除术，82%的患者接受了盂唇修复术。发现最常见的髋臼软骨损伤类型为贝克 2 级病变（43%）。3 级和 4 级病变分别见于 29%和 11%的患者。1 年时 HAGOS PROM 值在疼痛方面增加至中位数 69.1（四分位距[IQR]，68.2 至 70.0），症状方面增加至中位数 64.9（IQR，64.0 至 65.7），日常生活活动方面增加至中位数 71.3（IQR，70.3 至 72.3），运动方面增加至中位数 56.2（IQR，55.1 至 57.4），身体活动方面增加至中位数 42.2（IQR，40.8 至 43.5），生活质量方面增加至中位数 50.7（IQR，49.7 至 51.8），1 年时 EQ-5D 增加至中位数 0.75（IQR，0.74 至 0.76）。383 例患者的 5 年结果显示所有 PROMs 均显著改善（p < 0.05）。
接受髋关节镜检查的患者在手术前报告有疼痛、功能障碍和活动水平及生活质量下降，但在 1 年和 5 年后均有改善。描述了开发和维护大型临床注册中心所面临的问题。髋关节镜检查的全国临床注册中心的发展被认为是成功的。
治疗性 IV 级。欲了解完整的证据水平描述，请参见作者说明。
