Fernandez Claire E, Morgan Allison M, Sheth Ujash, Tjong Vehniah K, Terry Michael A
Department of Orthopaedic Surgery, Northwestern University, 259 East Erie, 13th Floor, Chicago, IL 60611, USA.
J Hip Preserv Surg. 2020 Mar 28;7(2):225-232. doi: 10.1093/jhps/hnaa013. eCollection 2020 Jul.
One in four patients presenting with femoroacetabular impingement (FAI) has bilateral symptoms, and despite excellent outcomes reported after arthroscopic treatment of FAI, there remains a paucity of data on the outcomes following bilateral hip arthroscopy. This systematic review aims to examine the outcomes following bilateral (either 'simultaneous' or 'staged') versus unilateral hip arthroscopy for FAI. A systematic review of multiple electronic databases was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. All studies comparing simultaneous, staged and/or unilateral hip arthroscopy for FAI were eligible for inclusion. Case series, case reports and reviews were excluded. All study, patient and hip-specific data were extracted and analyzed. The Newcastle-Ottawa Scale was used to assess study quality. A meta-analysis was not performed due to heterogeneity among outcome measures. A total of six studies, including 722 patients (42.8% male) and 933 hips were eligible for inclusion. The mean age across patients was 35.5. The average time between staged procedures was 7.7 months. Four of the six studies were retrospective cohort studies, while the remaining two were prospective in nature. The overall quality of the eligible studies was found to be good. No significant difference was noted among patient-reported outcomes (modified Harris hip score, hip outcome score and non-arthritic hip score), visual analog scale, return to sport, traction time and complications between those undergoing bilateral (simultaneous or staged) versus unilateral hip arthroscopy. Based on the current available evidence, bilateral hip arthroscopy (whether simultaneous or staged) exhibits similar efficacy and safety when compared with unilateral hip arthroscopy. However, further prospective study is required to confirm this finding.
四分之一的股骨髋臼撞击症（FAI）患者有双侧症状，尽管关节镜治疗FAI后报告了良好的治疗效果，但关于双侧髋关节镜检查后治疗效果的数据仍然很少。本系统评价旨在研究双侧（“同期”或“分期”）与单侧髋关节镜检查治疗FAI后的效果。使用系统评价和Meta分析的首选报告项目（PRISMA）指南和清单对多个电子数据库进行了系统评价。所有比较同期、分期和/或单侧髋关节镜检查治疗FAI的研究均符合纳入标准。排除病例系列、病例报告和综述。提取并分析了所有研究、患者和髋关节特异性数据。使用纽卡斯尔-渥太华量表评估研究质量。由于结局指标存在异质性，未进行Meta分析。共有6项研究符合纳入标准，包括722例患者（42.8%为男性）和933个髋关节。患者的平均年龄为35.5岁。分期手术之间的平均时间为7.7个月。6项研究中有4项为回顾性队列研究，其余2项为前瞻性研究。发现符合条件的研究的总体质量良好。在患者报告的结局（改良Harris髋关节评分、髋关节结局评分和非关节炎髋关节评分）、视觉模拟量表、恢复运动情况、牵引时间以及双侧（同期或分期）与单侧髋关节镜检查患者之间的并发症方面，未发现显著差异。基于目前可得的证据，与单侧髋关节镜检查相比，双侧髋关节镜检查（无论是同期还是分期）显示出相似的疗效和安全性。然而，需要进一步的前瞻性研究来证实这一发现。
