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脊柱下髋关节撞击症:关节镜治疗的临床及影像学结果

Subspine Hip Impingement: Clinical and Radiographic Results of its Arthroscopic Treatment.

作者信息

Roos Bruno Dutra, Roos Milton Valdomiro, Camisa Júnior Antero, Lima Ezequiel Moreno Ungaretti, Fontana Mariano Feraboli, Okamoto Roger Pires

机构信息

Serviço de Cirurgia do Quadril, Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2020 Dec;55(6):722-727. doi: 10.1055/s-0040-1713760. Epub 2020 Sep 22.

Abstract

To evaluate the clinical and radiographic results as well as complications related to patients undergoing arthroscopic treatment of subspine hip impingement.  We retrospectively evaluated 25 patients (28 hips) who underwent arthroscopic treatment of subspine impingement between January 2012 and June 2018. The mean follow-up was 29.5 months, and the patients were evaluated clinically by using the Harris hip score modified by Byrd (MHHS), the non-arthritic hip score (NAHS), and in terms of internal rotation and hip flexion. In addition, the following items were evaluated by imaging exams: the center-edge (CE) acetabular angle, the Alpha angle, the presence of a sign of the posterior wall, the degree of arthrosis, the presence of heterotopic hip ossification, and the Hetsroni classification for subspine impingement.  There was an average postoperative increase of 26.9 points for the MHHS, 25.4 for the NAHS (  < 0.0001), 10.5° in internal rotation (  < 0.0024), and 7.9° for hip flexion (  < 0.0001). As for the radiographic evaluation, an average reduction of 3.3° in the CE angle and of 31.6° for the Alpha angle (  < 0.0001). Eighteen cases (64.3%) were classified as grade 0 osteoarthritis of Tönnis, and 10 (35.7%) were classified as Tönnis grade 1. Two cases (7.1%) presented grade 1 ossification of Brooker. Most hips (  = 15, 53.6%) were classified as type II of Hetsroni et al.  In the present study, patients undergoing arthroscopic treatment with subspine impingement showed improvement in clinical aspects and radiographic patterns measured postoperatively, with an average follow-up of 29.5 months.

摘要

评估关节镜治疗髋臼盂唇撞击症患者的临床和影像学结果以及相关并发症。我们回顾性评估了2012年1月至2018年6月期间接受关节镜治疗髋臼盂唇撞击症的25例患者(28髋)。平均随访时间为29.5个月,通过使用Byrd改良的Harris髋关节评分(MHHS)、非关节炎髋关节评分(NAHS)对患者进行临床评估,并评估内旋和髋关节屈曲情况。此外,通过影像学检查评估以下项目:中心边缘(CE)髋臼角、阿尔法角、后壁征的存在情况、关节病程度、髋关节异位骨化的存在情况以及髋臼盂唇撞击症的Hetsroni分类。术后MHHS平均提高26.9分,NAHS提高25.4分(P<0.0001),内旋增加10.5°(P<0.0024),髋关节屈曲增加7.9°(P<0.0001)。影像学评估方面,CE角平均减小3.3°,阿尔法角平均减小31.6°(P<0.0001)。18例(64.3%)被分类为Tönnis 0级骨关节炎,10例(35.7%)被分类为Tönnis 1级。2例(7.1%)出现Brooker 1级骨化。大多数髋关节(n = 15,53.6%)被分类为Hetsroni等人的II型。在本研究中,接受关节镜治疗髋臼盂唇撞击症的患者术后在临床方面和影像学表现上均有改善,平均随访时间为29.5个月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e777/7748928/4b37cdc59d3f/10-1055-s-0040-1713760-i2000001en-1.jpg

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