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髋关节撞击综合征的手术干预可改善合并慢性腰痛患者的髋关节和腰部功能:1 年随访结果

Surgical Intervention for Femoroacetabular Impingement Can Lead to Improvements in Both Hip and Back Function in Patients With Coexisting Chronic Back Pain at 1-Year Follow-Up.

机构信息

Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York, U.S.A.

Division of Sports Medicine, Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York, U.S.A..

出版信息

Arthroscopy. 2021 Apr;37(4):1163-1169.e1. doi: 10.1016/j.arthro.2020.11.043. Epub 2020 Dec 2.

Abstract

PURPOSE

To determine whether patients with coexisting lumbar back pain experience back pain improvement after undergoing hip arthroscopy for femoroacetabular impingement (FAI).

METHODS

An institutional review board-approved retrospective chart review compared patients undergoing hip arthroscopy for FAI with lumbar spine back pain to patients solely reporting hip pain. The modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS) were recorded preoperatively and at 1-year follow up. The Oswestry Disability Index score, which quantifies disability from lower back pain, and visual analog scale were recorded from the hip-spine cohort alone. Statistical analysis was performed using paired sample t tests with P ≤ .05 considered significant.

RESULTS

Sixty-eight patients who underwent hip arthroscopy between November 2016 and October 2018 were enrolled. Thirty-four patients with a mean age of 48.2 ± 14.0 years and body mass index of 26.6 ± 6.6 had a history of back pain and 34 patients were age- and sex-matched for the matched-control (MC) cohort. The MC cohort had lower mHHS and NAHS scores preoperatively. The MC cohort reported a larger increase in the mHHS (P = .01) and NAHS scores (P = .01) postoperatively. More patients in the MC cohort reached minimally clinically important difference with mHHS (P = .003) and NAHS (P = .06). Following surgery, the hip-spine cohort reported a lower Oswestry Disability Index score, indicating minimal disability (P = .01).

CONCLUSIONS

Surgical intervention for FAI can lead to improvements in hip and back pain in patients with coexisting lumbar pathology.

LEVEL OF EVIDENCE

III, retrospective comparative study.

摘要

目的

确定同时患有腰椎背痛的患者在接受髋关节镜检查治疗股骨髋臼撞击症(FAI)后,其背痛是否有所改善。

方法

一项机构审查委员会批准的回顾性图表审查比较了同时患有髋关节镜检查治疗 FAI 和腰椎背痛的患者与仅报告髋关节疼痛的患者。术前和 1 年随访时记录改良 Harris 髋关节评分(mHHS)和非关节炎髋关节评分(NAHS)。仅对髋关节脊柱队列记录下腰痛的 Oswestry 残疾指数评分和视觉模拟评分。使用配对样本 t 检验进行统计学分析,P≤0.05 认为有统计学意义。

结果

共纳入 2016 年 11 月至 2018 年 10 月期间接受髋关节镜检查的 68 例患者。34 例平均年龄 48.2±14.0 岁、体重指数 26.6±6.6 的患者有背痛史,34 例年龄和性别相匹配的患者为匹配对照组(MC)队列。MC 队列的 mHHS 和 NAHS 评分术前较低。MC 队列的 mHHS(P=0.01)和 NAHS 评分(P=0.01)术后有较大增加。MC 队列中更多患者达到 mHHS(P=0.003)和 NAHS(P=0.06)的最小临床重要差异。手术后,髋关节脊柱队列的 Oswestry 残疾指数评分较低,表明残疾程度较低(P=0.01)。

结论

FAI 的手术干预可以改善同时患有腰椎病变的患者的髋关节和背痛。

证据水平

III,回顾性比较研究。

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