股骨髋臼撞击症的发病率和随时间变化的手术治疗趋势。
Incidence of Femoroacetabular Impingement and Surgical Management Trends Over Time.
机构信息
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
Am J Sports Med. 2021 Jan;49(1):35-41. doi: 10.1177/0363546520970914. Epub 2020 Nov 23.
BACKGROUND
Femoroacetabular impingement (FAI) is a well-known cause of hip pain in adolescents and young adults. However, the incidence in the general population has not been clearly defined.
PURPOSE
To (1) define the population-based incidence of diagnosis of FAI in patients with hip pain, (2) report the trends in diagnosis of FAI over time, and (3) determine the changes in the rate and type of surgical management over time.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
A geographic database was used to identify patients who were 14 to 50 years old with hip pain between the years 2000 and 2016. Chart and radiographic review was performed to determine which patients had FAI. To be included, patients had to have a triad of clinical symptoms, physical examination signs, and imaging findings consistent with FAI. Medical records were reviewed to obtain demographic information, clinical history, physical examination findings, imaging details, and treatment details. Statistical analysis determined the overall age- and sex-adjusted annual incidence of FAI diagnosis and trends over time.
RESULTS
There were 1893 patients evaluated with hip pain, and 716 (38%; 813 hips) had diagnosed FAI. The mean ± SD age was 27.2 ± 8.4 years, and 67% were female. The incidence of FAI diagnosis was 54.4 per 100,000 person-years. Female patients had a higher incidence than male patients (73.2 vs 36.1 per 100,000 person-years; < .01). Incidence of FAI diagnosis were higher from 2010 to 2016 (72.6 per 100,000 person-years; < .01) as compared with 2005 to 2009 (45.3) and 2000 to 2004 (40.3). Hip arthroscopy, surgical hip dislocation, and periacetabular osteotomy utilization increased from the 2000-2004 to 2010-2016 periods, respectively: 1 (1%) to 160 (20%; = .04), 2 (1%) to 37 (5%; = .01), and 1 (1%) to 22 (3%; = .58).
CONCLUSION
The overall incidence of FAI diagnosis was 54.4 per 100,000 person-years, and it consistently increased between 2000 and 2016. Female patients had a higher incidence than male patients. The utilization of joint preservation operations, including hip arthroscopy, surgical hip dislocation, and anteverting periacetabular osteotomy, increased over time.
背景
股骨髋臼撞击症（FAI）是青少年和年轻成年人髋关节疼痛的一个已知病因。然而，其在普通人群中的发病率尚未明确界定。
目的
（1）定义髋关节疼痛患者中 FA 的基于人群的诊断发病率，（2）报告随时间推移 FA 诊断的趋势，以及（3）确定随时间推移手术管理的比率和类型的变化。
研究设计
队列研究；证据水平，3 级。
方法
使用地理数据库确定在 2000 年至 2016 年期间患有髋关节疼痛且年龄在 14 岁至 50 岁之间的患者。通过图表和影像学检查来确定哪些患者患有 FA。要被纳入研究，患者必须具有临床症状三联征、体格检查体征和影像学表现一致的 FA。对病历进行回顾以获取人口统计学信息、临床病史、体格检查结果、影像学细节和治疗细节。统计分析确定了 FA 诊断的总体年龄和性别调整后的年发病率以及随时间推移的趋势。
结果
共有 1893 例患者因髋关节疼痛接受了评估，其中 716 例（38%；813 髋）被诊断为 FA。平均±SD 年龄为 27.2±8.4 岁，67%为女性。FAI 诊断的发病率为 54.4/100,000 人年。女性患者的发病率高于男性患者（73.2 比 36.1/100,000 人年；<.01）。与 2005 年至 2009 年（45.3）和 2000 年至 2004 年（40.3）相比，2010 年至 2016 年 FA 诊断的发病率更高（72.6/100,000 人年；<.01）。髋关节镜检查、髋关节手术脱位和髋臼周围截骨术的使用率分别从 2000-2004 年至 2010-2016 年期间增加：1（1%）例至 160（20%；<.04）、2（1%）例至 37（5%；<.01）和 1（1%）例至 22（3%；<.58）。
结论
FAI 诊断的总体发病率为 54.4/100,000 人年，并且在 2000 年至 2016 年间持续增加。女性患者的发病率高于男性患者。关节保存手术的使用率，包括髋关节镜检查、髋关节手术脱位和前旋髋臼周围截骨术，随时间推移而增加。
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