Spectrum Health Medical Group Orthopedics & Sports Medicine, Grand Rapids, Michigan, USA.
Steadman Philippon Research Institute, Vail, Colorado, USA.
Am J Sports Med. 2021 Jan;49(1):76-81. doi: 10.1177/0363546520973977. Epub 2020 Dec 1.
Previous studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) in individuals 18 years of age and older. Long-term outcome data in the adolescent population, however, are limited.
To report 10-year outcomes after hip arthroscopy in adolescents with symptomatic FAI.
Case series; Level of evidence, 4.
Prospectively collected data were analyzed on adolescent patients younger than 18 years of age who had hip arthroscopy between March 2005 and 2009 with a minimum 10-year follow-up. Patients were included if they were diagnosed with symptomatic FAI and an associated labral tear that was treated with repair. Patients were excluded if they had previous hip procedures, acetabular dysplasia (lateral center-edge angle, <20°), avascular necrosis, previous hip fracture or dislocation, or Legg-Calve-Perthes disease, or refused to participate. The primary patient-reported outcome measure was the Hip Outcome Score (HOS) Activities of Daily Living (ADL) subscale. In addition, the HOS-Sport, modified Harris Hip Score (mHHS), 12-Item Short Form Health Survey (SF-12), and patient satisfaction were collected. Failure was defined as patients having to undergo revision arthroscopy.
There were 60 patients (70 hips) who met inclusion criteria and had a 10-year follow-up. The mean age of the cohort was 16 ± 1.2 years, with 21 male and 49 female hips. Seven hips (10%) required revision hip arthroscopy. All revisions occurred in female patients and were associated with global laxity as well as longer duration of symptoms before time of surgery. At a mean follow-up of 12 years (range, 10-14 years), patients who did not undergo revision surgery had significant improvements from preoperatively to postoperatively in HOS-ADL (from 64 to 92; < .01), HOS-Sport (from 40 to 86; < .01), mHHS (from 56 to 88; < .01), and SF-12 Physical Component Summary (from 41 to 54; < .01). The median patient satisfaction was 10 out of 10 (very satisfied).
Hip arthroscopy for FAI with labral repair resulted in excellent patient-reported outcomes and satisfaction at a minimum of 10 years of follow-up. There was a 10% rate of revision surgery, which was associated with global laxity and longer duration of symptoms before surgery, which should be considered in patient selection.
先前的研究表明，髋关节镜检查对于 18 岁及以上的股骨髋臼撞击症（FAI）患者是一种有效的治疗方法。然而，青少年人群的长期结果数据有限。
报告髋关节镜检查治疗青少年症状性 FAI 的 10 年结果。
病例系列；证据水平，4 级。
对 2005 年 3 月至 2009 年期间接受髋关节镜检查且随访时间至少 10 年的青少年患者进行前瞻性数据收集。如果患者被诊断为症状性 FAI 和相关的盂唇撕裂，并且采用修复治疗，则将其纳入研究。如果患者有先前的髋关节手术、髋臼发育不良（外侧中心边缘角，<20°）、股骨头坏死、先前的髋关节骨折或脱位、Legg-Calve-Perthes 病或拒绝参与，则将其排除在外。主要的患者报告结局测量指标是髋关节结果评分（HOS）日常生活活动（ADL）子量表。此外，还收集了 HOS-运动、改良 Harris 髋关节评分（mHHS）、12 项简明健康调查量表（SF-12）和患者满意度。失败的定义是患者需要接受翻修关节镜检查。
有 60 名患者（70 髋）符合纳入标准并进行了 10 年随访。该队列的平均年龄为 16±1.2 岁，其中 21 髋为男性，49 髋为女性。7 髋（10%）需要进行翻修髋关节镜检查。所有翻修均发生在女性患者中，与整体松弛以及手术前症状持续时间较长有关。在平均 12 年（范围为 10-14 年）的随访中，未接受翻修手术的患者在 HOS-ADL（从 64 分提高至 92 分；<0.01）、HOS-运动（从 40 分提高至 86 分；<0.01）、mHHS（从 56 分提高至 88 分；<0.01）和 SF-12 生理成分综合评分（从 41 分提高至 54 分；<0.01）方面均有显著改善。患者满意度中位数为 10 分（非常满意）。
髋关节镜检查治疗 FAI 伴盂唇修复可获得良好的患者报告结局和满意度，至少随访 10 年。翻修手术率为 10%，与整体松弛和手术前症状持续时间较长有关，在患者选择时应考虑这些因素。
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