Hip and Groin Clinic, University of Pittsburgh Medical Center Whitfield, Waterford, Ireland.
Hip and Groin Clinic, University of Pittsburgh Medical Center Whitfield, Waterford, Ireland.
Arthroscopy. 2021 Feb;37(2):566-576. doi: 10.1016/j.arthro.2020.10.035. Epub 2020 Oct 24.
To evaluate the impact of hip arthroscopy for femoroacetabular impingement (FAI) on both the physical and mental components of the 36-Item Short Form (SF-36) and assess how changes in health status compare with improvements in physical function and ability to continue to play (CTP) 2 years after surgery.
Data collected prospectively from male athletes undergoing primary arthroscopic correction of FAI between November 2008 and October 2016 were analyzed. Physical (PCS) and mental (MCS) component scores of the SF-36 were assessed preoperatively and 2 years postoperatively. The minimal clinical important difference (MCID) was calculated using an anchor-based percentage of possible improvement technique, and the proportion of athletes achieving MCID was established. Logistic regression analysis was used to identify predictors of achieving MCID. CTP was assessed at 2-year follow-up.
486 cases were included, age 25.9 ± 5.6 years. Median PCS improved from baseline 69.4 (51.9 to 85.0) to 91.9 (81.9 to 97.5) at 2 years (P < .001). Median MCS remained unchanged-preoperative, 88 (76 to 92); postoperative, 88 (80 to 96)-although the difference in the distribution of scores was statistically significant (P < .001). Calculated MCID was 60.1% (PCS) and 58.1% (MCS). Mean improvement was significantly higher for PCS compared with MCS (17.4 versus 3.7, P < .001) The proportion of cases achieving MCID was 56.9% and 28.7% for PCS and MCS, respectively, and the difference was statistically significant (P < .001). Lower Tonnis grade (odds ratio [OR] 0.601, 95% confidence interval [CI] 0.377 to 0.958; P = .032) and symptom duration <2 years (OR 0.624, 95% CI 0.406 to 0.960; P = .032) were predictive of achieving PCS MCID. Higher preoperative scores decreased the odds of achieving MCID (OR 0.965, 95% CI 0.955 to 0.975; P < .001; OR 0.972, 95% CI 0.958 to 0.986; P < .001 for PCS and MCS, respectively). 77.3% continued to play their main preinjury sport. Where CTP was not achieved, a significantly higher proportion of cases failed to meet MCID for the MCS compared with PCS (85% versus 60%, P < .001).
Arthroscopic management of sports-related FAI results in excellent overall clinical outcome and high levels of satisfaction and CTP at 2 years. Chronic hip injury has a significant negative effect on the physical and mental well-being of athletes; corrective surgery may restore physical function but is more limited in its ability to improve mental health status in this athletic cohort.
IV, therapeutic case series.
评估髋关节镜治疗股骨髋臼撞击症（FAI）对 36 项简短表格（SF-36）的身体和心理成分的影响，并评估手术后 2 年健康状况的变化与身体功能和继续比赛能力（CTP）的改善相比如何。
前瞻性分析 2008 年 11 月至 2016 年 10 月期间接受初次关节镜矫正 FAI 的男性运动员的数据。术前和术后 2 年评估 SF-36 的身体（PCS）和心理（MCS）成分评分。使用基于锚的可能改善百分比技术计算最小临床重要差异（MCID），并确定达到 MCID 的运动员比例。使用逻辑回归分析确定达到 MCID 的预测因素。在 2 年随访时评估 CTP。
纳入 486 例患者，年龄 25.9±5.6 岁。PCS 中位数从基线的 69.4（51.9 至 85.0）改善至术后 2 年的 91.9（81.9 至 97.5）（P<.001）。MCS中位数保持不变-术前，88（76 至 92）；术后，88（80 至 96）-尽管分数分布的差异具有统计学意义（P<.001）。计算的 MCID 为 60.1%（PCS）和 58.1%（MCS）。PCS 的平均改善明显高于 MCS（17.4 与 3.7，P<.001）。PCS 和 MCS 分别达到 MCID 的病例比例分别为 56.9%和 28.7%，差异具有统计学意义（P<.001）。较低的 Tonnis 分级（比值比[OR]0.601，95%置信区间[CI]0.377 至 0.958；P=.032）和症状持续时间<2 年（OR 0.624，95%CI0.406 至 0.960；P=.032）是达到 PCS MCID 的预测因素。较高的术前评分降低了达到 MCID 的可能性（OR 0.965，95%CI0.955 至 0.975；P<.001；OR 0.972，95%CI0.958 至 0.986；P<.001，用于 PCS 和 MCS）。77.3%继续从事主要的受伤前运动。在未达到 CTP 的情况下，与 PCS 相比，MCS 未能达到 MCID 的病例比例显著更高（85%比 60%，P<.001）。
关节镜治疗运动相关性 FAI 可在术后 2 年获得极佳的总体临床结果、高满意度和 CTP。慢性髋关节损伤对运动员的身心健康有显著的负面影响；矫形手术可能恢复身体功能，但在改善该运动队列的心理健康状况方面能力有限。
IV，治疗性病例系列。
