American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
AMITA Health St Alexius Medical Center, Hoffman Estates, Illinois, USA.
Am J Sports Med. 2020 Sep;48(11):2747-2754. doi: 10.1177/0363546520944147. Epub 2020 Aug 10.
Iliopsoas impingement (IPI) has been associated with a distinct lesion on the anterior labrum. Iliopsoas fractional lengthening (IFL) can treat IPI in instances of painful internal snapping (PIS) and mechanical groin pain.
To report minimum 2-year outcomes of patients without PIS who had an IPI lesion diagnosed intraoperatively that did not undergo IFL (+IPI -PIS -IFL) as compared with a matched group of patients with PIS and an IPI lesion that was treated with IFL (+IPI +PIS +IFL).
Cohort study; Level of evidence, 3.
Data on all patients who underwent primary hip arthroscopy between May 2009 and June 2017 were retrospectively reviewed. Patients were included if they underwent hip arthroscopy for femoroacetabular impingement-related pathology, an IPI lesion was diagnosed intraoperatively, and they had minimum 2-year postoperative scores for the following: modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), iHOT-12 (International Hip Outcome Tool-12), patient satisfaction, and visual analog score (VAS) for pain. Patients were propensity score matched based on the following criteria: age, body mass index, follow-up time, sex, labral treatment, femoroplasty, and acetabuloplasty.
A total of 412 hips were eligible for the current study, of which 336 (81.6%) had 2-year follow-up. The matching process established 37 hips in the +IPI -PIS -IFL group and 87 hips in the +IPI +PIS +IFL group. Both groups experienced significant improvements from presurgery to latest follow-up for all recorded patient-reported outcomes (PROs). The +IPI -PIS -IFL group compared favorably with the +IPI +PIS +IFL group for mHHS (86.0 vs 86.1; = .53), NAHS (83.0 vs 84.7; = .40), and HOS-SSS (78.1 vs 76.5; = .87). Additionally, iHOT-12, VAS, patient satisfaction, and rates of achieving the minimal clinically important difference for mHHS, NAHS, and HOS-SSS were similar between groups at the latest follow-up.
Patients without PIS who were diagnosed with an IPI lesion intraoperatively and did not undergo IFL had similar and favorable improvements in PROs, VAS, and satisfaction to a matched cohort with PIS who had IFL performed. Thus, an IPI lesion in the absence of PIS may not require IFL.
髂腰肌撞击症（IPI）与前唇的特定病变有关。髂腰肌部分延长术（IFL）可治疗有疼痛性内部弹响（PIS）和机械性腹股沟疼痛的 IPI。
报告在没有 PIS 的 IPI 病变患者中，未行 IFL（+IPI-PIS-IFL）的患者的至少 2 年结果，与 PIS 合并 IPI 病变且行 IFL 治疗（+IPI+PIS+IFL）的匹配组患者相比。
队列研究；证据水平，3 级。
回顾性分析 2009 年 5 月至 2017 年 6 月期间行初次髋关节镜检查的所有患者的数据。纳入标准为：接受髋关节镜检查治疗股骨髋臼撞击症相关病变，术中诊断为 IPI 病变，且术后至少有 2 年以下评分：改良 Harris 髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）、髋关节结果评分-运动特定分量表（HOS-SSS）、iHOT-12（国际髋关节结果工具-12）、患者满意度和疼痛视觉模拟评分（VAS）。根据以下标准对患者进行倾向评分匹配：年龄、体重指数、随访时间、性别、唇治疗、股骨成形术和髋臼成形术。
共有 412 髋符合当前研究标准，其中 336 髋（81.6%）有 2 年随访。匹配过程建立了+IPI-PIS-IFL 组 37 髋和+IPI+PIS+IFL 组 87 髋。两组患者在所有记录的患者报告结局（PROs）方面均从术前到最新随访有显著改善。与+IPI+PIS+IFL 组相比，+IPI-PIS-IFL 组的 mHHS（86.0 比 86.1；=0.53）、NAHS（83.0 比 84.7；=0.40）和 HOS-SSS（78.1 比 76.5；=0.87）更好。此外，iHOT-12、VAS、患者满意度以及 mHHS、NAHS 和 HOS-SSS 的最小临床重要差异的达到率在最新随访时在两组之间相似。
在没有 PIS 的情况下，术中诊断为 IPI 病变但未行 IFL 的患者，其 PROs、VAS 和满意度的改善与行 IFL 治疗的 PIS 合并 IPI 病变且行 IFL 治疗的匹配组相似。因此，无 PIS 的 IPI 病变可能不需要 IFL。
