髋关节镜术后囊袋关闭：我们的经验。
Capsular closure after hip arthroscopy: our experience.
机构信息
clinic of orthopaedics, University Hospital of Udine.
Clinic of Orthopaedics, Academic Hospital of Udine, Udine, Italy.
出版信息
Acta Biomed. 2020 May 30;91(4-S):92-97. doi: 10.23750/abm.v91i4-S.9664.
BACKGROUND AND AIM OF THE WORK
In the last decade, arthroscopic treatment of hip diseases has significantly spread and evolved and currently it represents the gold standard for the treatment of femoral- acetabular impingement. In the recent years, the function of the joint capsule (and therefore the results of an arthroscopic capsulotomy) has been hugely developed, opening a heated debate. The Literature is still torn about the need for a capsular suture, but more recent studies are more oriented in its execution at the end of the surgical procedure. According to these recent studies, the joint capsule performs an essential function of primary stability, and its closure is therefore necessary to restore the native anatomy and physiology. Nevertheless, capsular management remains a controversial topic. This is a retrospective study with the aim of assessing the influence of capsular suture on the patient's functional outcome in a cohort of patients with femoral-acetabular impingement arthroscopically treated.
HYPOTHESIS
Our hypothesis is that an adequate capsular suture positively influences the patient's functional outcome.
METHODS AND RESULTS
50 patients treated with hip arthroscopy for femoral-acetabular impingement have been retrospectively enrolled at the Orthopaedic Clinic of Academic Hospital of Udine during a period of two-years (2017-2018); collected data have been analysed and compared with a retrospective model. Patients have been divided into two equivalent groups, 25 treated with capsular suture, 25 without performing the suture. Patient's post-operative functional outcome has been analysed using the modified Harris Hip Score (mHHS), the Non-Arthritic Hip Score (NAHS) and the Hip Outcome Score-Sport Scale (HOS-SS). The functional outcome in patients where capsular sutures were performed was better than in non-sutured patients, in all three analysed scales.
CONCLUSIONS
Capsular suture with a single side-to-side stitch at the end of the procedure can positively influence the patient's functional outcome.
背景与目的
在过去的十年中，关节镜治疗髋关节疾病得到了显著的发展和普及，目前已成为治疗股骨髋臼撞击症的金标准。近年来，关节囊的功能（因此关节镜下囊切开术的结果）得到了极大的发展，引发了激烈的争论。文献对于是否需要缝合关节囊仍存在分歧，但最近的研究更倾向于在手术结束时进行缝合。根据这些最近的研究，关节囊具有重要的初始稳定性功能，因此闭合关节囊对于恢复正常解剖和生理功能是必要的。然而，关节囊的处理仍然是一个有争议的话题。这是一项回顾性研究，旨在评估在一组接受关节镜治疗的股骨髋臼撞击症患者中，关节囊缝合对患者功能结果的影响。
假设
我们的假设是，适当的关节囊缝合会对患者的功能结果产生积极影响。
方法和结果
在两年期间（2017-2018 年），我们在乌迪内学术医院骨科诊所回顾性地招募了 50 名接受髋关节镜治疗股骨髋臼撞击症的患者；收集的数据进行了分析，并与回顾性模型进行了比较。患者被分为两组，每组 25 名，一组进行关节囊缝合，一组不进行缝合。使用改良 Harris 髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）和髋关节结果评分-运动量表（HOS-SS）分析患者术后的功能结果。在所有三个分析的量表中，进行关节囊缝合的患者的功能结果都优于未缝合的患者。
结论
在手术结束时进行单侧关节囊缝合可以积极影响患者的功能结果。
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