Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main St. W. 4E15, HamiltonHamilton, ON, L8N 3Z5, Canada.
Mercy Health - Cincinnati Sports Medicine and Orthopaedic Center, Cincinnati, OH, USA.
Knee Surg Sports Traumatol Arthrosc. 2021 May;29(5):1362-1369. doi: 10.1007/s00167-020-06401-x. Epub 2021 Jan 2.
To understand the early outcomes after hip arthroscopy and better define the trajectory of improvement in a prospective cohort of patients who have undergone hip arthroscopic osteochondroplasty for femoroacetabular impingement (FAI) syndrome.
Data were analyzed from the Femoroacetabular Impingement RandomiSed controlled Trial (FIRST) on the 108 study patients who underwent osteochondroplasty, with or without labral repair. Study outcomes included patient-reported pain (using a 100-point Visual Analogue Scale (VAS)), hip function (using the Hip Outcome Score (HOS) and International Hip Outcome Tool (iHOT-12)), and health-related quality of life (using the EuroQol 5 Dimensions (EQ-5D)) measured at baseline, 2 weeks, 3 months, 6 months, and 12 months post-operatively.
There was a decrease in mean post-operative pain VAS scores from baseline. The first 2 weeks post-operative yielded the greatest reduction in pain with a mean (SD) VAS score of 37.8 (23.4), with score stabilization between 6 months (26.9 (26.9)) and 12 months (25.3 (27.6)). Mean HOS (activities of daily living) scores improved from baseline (59.7 (16.2)) starting at 6 weeks post-operative (64.1 (19.1)). The HOS (Sports) showed no improvement from baseline (41.2 (20.4)) until 3 months (49.1 (27.9)), and continued to improve at 6 months (64.1 (28.7)) and 12 months (68.6 (30.5)). The iHOT-12 scores showed functional improvement from baseline (31.3 (18.8)), as early as 6 weeks (44.9 (22.4)) up to and including 12 months (67.1 (29.7)). EQ-5D index scores showed modest steady improvement from 6 weeks to 12 months post-operative, while the EQ-5D VAS component similarly showed modest and steady improvements from 3 months onward.
Results from this study highlight that hip arthroscopic osteochondroplasty with or without labral repair for FAI leads to early pain relief. While all scores improved from baseline, functional gains appear to plateau from 6 months onwards. These data can be used to inform decision-making about timelines for rehabilitation and return to sport, a knowledge gap in the current FAI literature.
II.
通过前瞻性队列研究，了解髋关节镜下骨软骨成形术治疗股骨髋臼撞击综合征（FAI）患者的早期结果，并更好地定义改善轨迹。
对 Femoroacetabular Impingement RandomiSed controlled Trial（FIRST）中 108 例接受骨软骨成形术（伴或不伴盂唇修复）的患者进行数据分析。研究结果包括患者报告的疼痛（使用 100 分视觉模拟量表（VAS））、髋关节功能（使用髋关节结果评分（HOS）和国际髋关节结果工具（iHOT-12））和健康相关生活质量（使用 EuroQol 5 维度（EQ-5D）），分别在基线、术后 2 周、3 个月、6 个月和 12 个月时进行测量。
术后平均疼痛 VAS 评分从基线下降。术后前 2 周疼痛减轻最大，平均 VAS 评分为 37.8（23.4），6 个月（26.9（26.9））和 12 个月（25.3（27.6））之间评分稳定。术后 6 周（64.1（19.1））开始，HOS（日常生活活动）评分从基线（59.7（16.2））开始提高。HOS（运动）直到 3 个月（49.1（27.9））才从基线开始改善（41.2（20.4）），并在 6 个月（64.1（28.7））和 12 个月（68.6（30.5））时继续改善。iHOT-12 评分从基线（31.3（18.8））开始显示功能改善，早在 6 周（44.9（22.4）），直到 12 个月（67.1（29.7））。EQ-5D 指数评分从术后 6 周到 12 个月均有适度稳定的改善，而 EQ-5D VAS 成分从 3 个月起也表现出适度和稳定的改善。
本研究结果表明，髋关节镜下骨软骨成形术（伴或不伴盂唇修复）治疗 FAI 可早期缓解疼痛。虽然所有评分均从基线开始改善，但功能改善似乎从 6 个月开始趋于稳定。这些数据可用于为康复和重返运动的时间安排提供决策依据，这是当前 FAI 文献中的一个知识空白。
II 级。
