American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.
American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.; AMITA Health St. Alexius Medical Center, Hoffman Estates, Illinois, U.S.A.
Arthroscopy. 2021 Oct;37(10):3090-3101. doi: 10.1016/j.arthro.2021.03.057. Epub 2021 Apr 30.
(1) To investigate intra-articular damage in the hip joint associated with subspine impingement (SSI); (2) to evaluate clinical outcomes of arthroscopic treatment of hips with SSI; and (3) to compare the findings and outcomes to a control group without SSI.
Eligible patients had arthroscopic treatment for femoroacetabular impingement (FAI) concurrent with SSI between January 2015 and December 2017. Inclusion criteria consisted of preoperative and minimum 2-year patient-reported outcomes and preoperative measurements for Tönnis, lateral center edge angle, and alpha angle. Included patients were propensity-matched in a 1:3 ratio to patients who had FAI without SSI. Patient-reported outcomes were compared between groups. Minimal clinically important difference was calculated for modified Harris Hip Score (mHHS) and Hip Outcome Score-Sports Specific Subscale (HOS-SSS).
Fifty SSI cases were matched to 150 patients who had FAI without SSI. A greater proportion of the SSI cohort required labral reconstruction (P = .010). The size and locations for labral tears and chondral defects were comparable between groups (P > .05). Both groups demonstrated similar minimum 2-year outcomes for mHHS (P = .103), Nonarthritic Hip Score (P = .200), HOS-SSS (P = .119), visual analog scale (P = .231), international Hip Outcome Tool-12 (P =.300), Short Form-12 Mental (P = .426), Short Form-12 Physical (P = .328), Veterans RAND 12-Item Health Survey, Mental (P = .419), and Veterans RAND 12-Item Health Survey, Physical (P = .316). The percentage of patients achieving minimal clinically important difference for mHHS and HOS-SSS was similar (P > .05). Survivorship was 96.0% and 98.7% for the SSI and control cohorts at 2 years, respectively.
Arthroscopic treatment of hips with SSI with subspine decompression and concomitant treatment of labral tears and FAI yielded significant improvement in patients' outcomes, which compared favorably with the control group. SSI may correlate with more complex labral tears, not amenable to repair, and complete tears of the ligamentum teres. Other findings, such as location and size of intra-articular damage, were similar between the cohorts.
III, case-control study.
（1）研究与小柱撞击（SSI）相关的髋关节内关节损伤；（2）评估关节镜治疗伴有 SSI 的髋关节的临床效果；（3）并将结果与无 SSI 的对照组进行比较。
符合条件的患者于 2015 年 1 月至 2017 年 12 月期间因股骨髋臼撞击（FAI）合并 SSI 接受了关节镜治疗。纳入标准包括术前和至少 2 年的患者报告结果，以及术前 Tönnis、外侧中心边缘角和 α 角的测量值。将术前存在 SSI 的患者按 1:3 的比例与无 SSI 的 FAI 患者进行倾向性匹配。对两组患者的患者报告结果进行比较。对改良 Harris 髋关节评分（mHHS）和髋关节结果评分-运动特异性量表（HOS-SSS）进行最小临床重要差异计算。
50 例 SSI 患者与 150 例无 SSI 的 FAI 患者进行了匹配。SSI 组中需要进行盂唇重建的比例更高（P=0.010）。两组盂唇撕裂和软骨缺损的大小和位置相似（P>0.05）。两组患者的 mHHS（P=0.103）、非关节炎髋关节评分（P=0.200）、HOS-SSS（P=0.119）、视觉模拟评分（P=0.231）、国际髋关节结果工具-12（P=0.300）、SF-12 精神量表（P=0.426）、SF-12 躯体量表（P=0.328）、退伍军人 RAND 12 项健康调查，精神量表（P=0.419）和退伍军人 RAND 12 项健康调查，躯体量表（P=0.316）在至少 2 年的最低临床重要差异方面的结果相似（P>0.05）。SSI 组和对照组患者的 mHHS 和 HOS-SSS 达到最小临床重要差异的百分比相似（P>0.05）。SSI 组和对照组患者的 2 年生存率分别为 96.0%和 98.7%。
伴有小柱减压和伴发盂唇撕裂和 FAI 的 SSI 髋关节关节镜治疗可显著改善患者的预后，与对照组相比结果良好。SSI 可能与更复杂的盂唇撕裂、无法修复和圆韧带完全撕裂有关。两组患者的其他发现，如关节内损伤的位置和大小，相似。
III，病例对照研究。
