Hip Unit, Department of Orthopedic Surgery, HLA Clinica Vistahermosa, Av de Denia 76, 03016, Alicante, Spain.
Int Orthop. 2020 Dec;44(12):2567-2575. doi: 10.1007/s00264-020-04810-8. Epub 2020 Sep 21.
The purpose of this study was to assess intra-operative findings, surgical procedures, and outcomes in a cohort of patients with borderline hip dysplasia treated with arthroscopic labral repair, femoral osteoplasty, and capsular plication, and compare these outcomes with those of a rigorously matched control group without dysplasia.
Data were prospectively collected and retrospectively reviewed for patients with a lateral center-edge angle between 20 and 24° who underwent hip arthroscopy surgery between 2014 and 2018. Labral, chondral status, psoas impingement, ligamentum teres, and cam morphology were evaluated. Patient-reported outcomes (PROs) scores included modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living Subscale (HOS-AVD) and Hip Outcome Score Sport-Specific Subscale (HOS-SSS), and International Hip Outcome Tool-12 (IHOT-12). Clinical relevance was measured with the minimal clinical important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB).
Twenty patients met the inclusion criteria. An age- and sex-matched control group of 40 patients was also selected. Arthroscopic intra-operative findings were similar between cohorts. At a mean follow-up of 50 months in the borderline hip dysplasia cohort, and 52 months in the control cohort, there was a significant improvement in PROs in both cohorts, and no significant differences could be detected at the latest follow-up. The difference in frequency of patients achieving the MCID, PASS, and SCB was not statistically significant between cohorts.
With strict patient selection criteria, hip arthroscopy may be a beneficial approach in patients with borderline hip dysplasia.
本研究旨在评估一组接受关节镜下盂唇修复、股骨成形术和囊袋紧缩术治疗的边界性髋关节发育不良患者的术中发现、手术过程和结果，并将这些结果与无发育不良的严格匹配对照组进行比较。
数据是前瞻性收集的，并对 2014 年至 2018 年间接受髋关节镜手术的外侧中心边缘角在 20 至 24°之间的患者进行了回顾性分析。评估了盂唇、软骨状况、腰大肌撞击、圆韧带和凸轮形态。患者报告的结果（PROs）评分包括改良 Harris 髋关节评分（mHHS）、髋关节结果评分日常生活活动量表（HOS-AVD）和髋关节结果评分运动特异性量表（HOS-SSS）以及国际髋关节结果工具-12（IHOT-12）。临床相关性通过最小临床重要差异（MCID）、患者可接受的症状状态（PASS）和实质性临床获益（SCB）来衡量。
20 名患者符合纳入标准。还选择了一组年龄和性别匹配的 40 名对照组患者。两组的关节镜术中发现相似。在边界性髋关节发育不良组的平均随访 50 个月和对照组的 52 个月时，两组的 PROs 均有显著改善，且在最新随访时无显著差异。在达到 MCID、PASS 和 SCB 的患者频率方面，两组之间没有统计学差异。
在严格的患者选择标准下，髋关节镜可能是治疗边界性髋关节发育不良患者的有益方法。
