Department of Radiology, Hamilton General Hospital, McMaster University, 237 Barton St. East, Hamilton, Ontario, L9L 2X2, Canada.
Department of Orthopedic Surgery, McMaster University Medical Centre, 1200 Main St West, 4E15, Hamilton, Ontario, L8N 3Z5, Canada.
Skeletal Radiol. 2021 Dec;50(12):2541-2548. doi: 10.1007/s00256-021-03766-z. Epub 2021 Apr 12.
To explore a novel ultrasound-guided injection technique of releasing extra-articular anterior hip adhesions in arthroscopically treated femoroacetabular impingement patients.
IRB-approved pilot study included 24 consecutive patients referred for ultrasound-guided injection (Jan 1, 2017-Mar 31, 2018) with anterior hip pain and/or limited hip flexion following arthroscopic treatment for femoroacetabular impingement. They underwent ultrasound-guided pressure injection, releasing post-operative extra-articular adhesions between the joint capsule and flexor tendons along the arthroscopic portal followed by steroid instillation. A visual analogue pain score of 0-10 and standard Hip Outcome Score was used to record treatment response pre-injection, at 6 weeks and at 6 months following injection.
Nine out of 11 patients (complete data group) who answered all questionnaires showed response to injection with improvement in Hip Outcome Scores at 6 weeks and 6 months. Three out of 10 patients (incomplete data group) showed significant response to injection from clinical follow-up records. No records were available in 3 patients. In total, 12 (57.14%) out of 21 patients showed response to injection. No post-procedure complications.
Ultrasound-guided pressure injection is a novel, safe, and effective procedure providing pain relief and improved hip movement as evaluated in our small sample study. The limitations of this pilot project include small sample size, lack of control group, short 6-month follow-up, and single institution study. This minimally invasive technique could be a cost-effective alternative to surgical adhesiolysis and can potentially be extended for extra-articular adhesions at other peripheral joints, amenable to ultrasound.
探索一种新的关节镜下治疗股骨髋臼撞击症患者髋关节外粘连的超声引导注射技术。
经机构审查委员会批准的初步研究纳入了 24 例连续患者，这些患者因髋关节镜治疗股骨髋臼撞击症后出现髋关节前侧疼痛和/或髋关节活动度受限而接受超声引导注射治疗（2017 年 1 月 1 日至 2018 年 3 月 31 日）。他们接受了超声引导下压力注射，在关节镜入路处释放关节囊和屈肌腱之间的术后关节外粘连，然后进行皮质类固醇注射。在注射前、6 周和 6 个月时使用视觉模拟疼痛评分（0-10 分）和髋关节评分标准来记录治疗反应。
在回答所有问卷的 11 名患者中（完整数据组），9 名患者（90%）显示出对注射的反应，髋关节评分在 6 周和 6 个月时得到改善。10 名患者中的 3 名（不完整数据组）从临床随访记录中显示出对注射的显著反应。3 名患者无记录。总共 21 名患者中有 12 名（57.14%）对注射有反应。无术后并发症。
超声引导下压力注射是一种新的、安全有效的方法，可提供疼痛缓解和髋关节运动改善，我们的小样本研究对此进行了评估。该初步研究的局限性包括样本量小、缺乏对照组、6 个月随访时间短以及单中心研究。这种微创技术可能是外科松解术的一种具有成本效益的替代方法，并且可以潜在地扩展到其他可超声检查的外周关节的关节外粘连。
