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采用缝线锚钉行股骨成形术治疗伴有和不伴有软骨盂唇稳定的波状信号。

Treatment of the Wave Sign With Femoral Osteoplasty With and Without Chondrolabral Stabilization Using Suture Anchors.

机构信息

Department of Orthopaedics, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A..

Department of Orthopaedics, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A.

出版信息

Arthroscopy. 2021 Apr;37(4):1155-1160. doi: 10.1016/j.arthro.2020.11.048. Epub 2020 Dec 2.

Abstract

PURPOSE

To discuss the surgical outcomes of patients identified to have the wave sign without an accompanying labral tear treated with and without stabilization of the chondrolabral junction in conjunction with femoral osteoplasty.

METHODS

A retrospective study was performed in patients with cartilage delamination (wave sign) treated with femoral osteoplasty alone (FO group) or femoral osteoplasty with chondrolabral stabilization (CLS group). Patient-reported outcomes including the modified Harris Hip Score, Hip Outcome Score (HOS)-Activities of Daily Living, and HOS-Sports-Specific Subscale were obtained at a minimum of 2 years postoperatively. Other outcomes included rates of revision hip arthroscopy and conversion to hip arthroplasty.

RESULTS

The study consisted of 47 patients in the FO group and 38 in the CLS group. Both groups showed significant increases in all patient-reported outcomes over the study period compared with preoperative values. The final modified Harris Hip Score was 72.8 ± 9.2 in the FO group and 79.9 ± 9.3 in the CLS group (P < .001). The HOS-Activities of Daily Living in the FO and CLS groups was 81.4 ± 10.3 and 87.2 ± 7.5, respectively (P < .001). There was no difference in the HOS-Sports-Specific Subscale between the FO group (74.4 ± 10.3) and the CLS group (78.0 ± 14.6) at final follow-up (P = .198). Revision hip arthroscopy was required in 5 patients in the FO group (13%) and 3 in the CLS group (6.3%). No patient in either group required conversion to hip arthroplasty throughout the study period.

CONCLUSIONS

Chondrolabral stabilization in conjunction with femoral osteoplasty is an effective treatment in patients with the wave sign without labral tears.

LEVEL OF EVIDENCE

Level III, retrospective cohort study.

摘要

目的

探讨伴有或不伴有盂唇撕裂的“波状征”患者行软骨-盂唇交界固定术联合股骨成形术的手术效果。

方法

对仅行股骨成形术(FO 组)或股骨成形术联合软骨-盂唇固定术(CLS 组)治疗的软骨分层(波状征)患者进行回顾性研究。所有患者至少随访 2 年,采用改良 Harris 髋关节评分、髋关节评分(HOS)-日常生活活动量表和 HOS-运动专项量表评估患者报告的结果。其他结果包括髋关节镜翻修率和髋关节置换术转换率。

结果

FO 组 47 例,CLS 组 38 例。两组患者在研究期间的所有患者报告结果均较术前显著提高。FO 组的最终改良 Harris 髋关节评分为 72.8 ± 9.2,CLS 组为 79.9 ± 9.3(P<0.001)。FO 组和 CLS 组的 HOS-日常生活活动量表分别为 81.4 ± 10.3 和 87.2 ± 7.5(P<0.001)。FO 组(74.4 ± 10.3)和 CLS 组(78.0 ± 14.6)的 HOS-运动专项量表在末次随访时无差异(P=0.198)。FO 组有 5 例(13%)和 CLS 组有 3 例(6.3%)患者需要行髋关节镜翻修术。在整个研究期间,两组均无患者需要行髋关节置换术。

结论

伴有或不伴有盂唇撕裂的“波状征”患者行软骨-盂唇交界固定术联合股骨成形术是一种有效的治疗方法。

证据等级

III 级,回顾性队列研究。

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