Instituto Cugat, Hospital Quiron Barcelona Floor -1, Pza., Alfonso Comín 5, 08023, Barcelona, Spain.
Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, Barcelona, Spain.
Knee Surg Sports Traumatol Arthrosc. 2021 May;29(5):1502-1509. doi: 10.1007/s00167-021-06484-0. Epub 2021 Feb 8.
Arthroscopic surgery is a usual technique to repair hip femoroacetabular impingement. Correlation exists among surgical indication, postoperative evolution, the final result, and the necessity of prosthesis in the near future. The assessment of specific parameters allowing us to evaluate the prognosis becomes vital to improve the results. The objective of this study is to check the variables found in patients with femoroacetabular impingement (FAI) treated with hip arthroscopy, and determine which of these variables would serve as key indicators in predicting the need for subsequent arthroplasty.
Data from FAI surgical indications (age, weight, height, BMI, gender, side, radiographic Tönnis degree, cartilage lesion degree by Acetabular Labrum Articular Disruption (ALAD) degree, VAS value, HOS, mHHS and WOMAC) were collected from cases which should have had a minimum monitoring period of 2 years from 2007 to 2017. The results of the group which needed prosthesis were compared to the results of the ones who did not.
Among 452 patients who were monitored for an average of 5.8 years, 82 (18.1%) required conversion to prosthesis. The variables that indicated relatively high risk were fourth-degree acetabular labrum articular disruption (ALAD) chondral injury, preoperative radiographic Grade 2 Tönnis classification, age of over 55 years, WOMAC over 45 points, and HOS-ADL under 50 points. There were no significant differences between side, gender, VAS level, nor HOS.
The presence of chondral injuries such as acetabular labrum articular disruption (ALAD) 4, radiographic Grade 2 Tönnis classification, higher age, higher BMI, and worse WOMAC, along with mHHS and HOS-ADL preoperative results, are factors which lead to a poor prognosis following FAI hip arthroscopic surgery, increasing the risk of prosthetic conversion in the short or medium term.
Level IV.
关节镜手术是修复髋关节股骨髋臼撞击症的常用技术。手术适应证、术后演变、最终结果以及近期内是否需要假体之间存在相关性。评估特定参数对于改善结果至关重要，这些参数可以帮助我们评估预后。本研究的目的是检查髋关节镜治疗的股骨髋臼撞击症（FAI）患者的变量，并确定哪些变量可作为预测后续关节置换术需求的关键指标。
从 2007 年至 2017 年，收集 FAI 手术适应证（年龄、体重、身高、BMI、性别、侧别、放射学 Tönnis 分级、髋臼唇关节突关节破坏（ALAD）分级的软骨损伤程度、VAS 值、HOS、mHHS 和 WOMAC）的数据。将需要假体的组的结果与不需要假体的组的结果进行比较。
在平均随访 5.8 年的 452 例患者中，82 例（18.1%）需要转换为假体。提示风险较高的变量包括髋臼唇关节突关节破坏（ALAD）四度软骨损伤、术前放射学分级 2 Tönnis 分级、年龄超过 55 岁、WOMAC 超过 45 分以及 HOS-ADL 低于 50 分。侧别、性别、VAS 水平以及 HOS 之间无显著差异。
存在软骨损伤，如髋臼唇关节突关节破坏（ALAD）4 级、放射学分级 2 Tönnis 分级、年龄较大、BMI 较高以及 WOMAC 较差，以及术前 mHHS 和 HOS-ADL 结果较差等因素，会导致 FAI 髋关节镜手术后预后不良，增加短期内或中期内假体转换的风险。
IV 级。
