Goyal Tarun, Barik Sitanshu, Gupta Tushar
Department of Orthopaedic Surgery, All India Institute of Medical Sciences, Rishikesh, India.
Hip Pelvis. 2021 Mar;33(1):3-10. doi: 10.5371/hp.2021.33.1.3. Epub 2021 Mar 2.
There is no clear evidence on indications and outcomes of hip arthroscopy in sequelae of Legg-Calve-Perthes disease (LCPD). The aim of the current study was to evaluate current literature on the role and outcome of hip arthroscopy in LCPD. A literature search using four databases was conducted in April 2020, focusing on the role of hip arthroscopy in sequelae of LCPD. A systematic search was carried out in confirmation with the Cochrane Collaboration, Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of nine studies were included in the systematic review. The total number of hip arthroscopies performed for LCPD was 109. The mean age of included patients was 34.8±7.88 years (7-58 years). Recalcitrant hip pain was the main indication for surgery, followed by pain and stiffness. The most common finding in arthroscopy was labral tears, followed by osteochondral lesions of femoral head or acetabulum and intra-articular loose bodies. Consequently, debridement of labrum tears chondroplasty for cartilage defects and osteoplasty for impingement from deformed femoral head (hinged abduction) were commonly performed. A significant improvement in hip function was seen in all studies. Pooled data of Harris hip score showed significant improvement after surgery was conducted. Hip arthroscopy may be beneficial in patients having symptoms of impingement secondary to changes in labrum, femoral head or acetabulum. Limited evidence shows improved function and range of motion after surgery. This treatment has been found to be safe in terms of complication rates and improvement may persist for years.
关于髋关节镜检查在Legg-Calve-Perthes病（LCPD）后遗症中的适应证和治疗结果，目前尚无明确证据。本研究的目的是评估当前关于髋关节镜检查在LCPD中的作用和治疗结果的文献。2020年4月，我们使用四个数据库进行了文献检索，重点关注髋关节镜检查在LCPD后遗症中的作用。按照Cochrane协作网、系统评价和Meta分析的首选报告项目指南进行了系统检索。系统评价共纳入9项研究。因LCPD而进行的髋关节镜检查总数为109例。纳入患者的平均年龄为34.8±7.88岁（7 - 58岁）。顽固性髋关节疼痛是手术的主要适应证，其次是疼痛和僵硬。关节镜检查最常见的发现是盂唇撕裂，其次是股骨头或髋臼的骨软骨损伤以及关节内游离体。因此，通常会对盂唇撕裂进行清创、对软骨缺损进行软骨成形术以及对变形股骨头（铰链外展）引起的撞击进行骨成形术。所有研究均显示髋关节功能有显著改善。Harris髋关节评分的汇总数据显示手术后有显著改善。髋关节镜检查可能对因盂唇、股骨头或髋臼改变而出现撞击症状的患者有益。有限的证据表明手术后功能和活动范围有所改善。就并发症发生率而言，这种治疗方法已被证明是安全的，而且改善可能会持续数年。
