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髋关节镜治疗中青年髋关节盂唇钙化的临床疗效。

Clinical Outcomes of Hip Arthroscopy for Hip Labrum Calcification in Young and Middle-Aged Patients.

机构信息

Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China.

Department of Sports Injury and Arthroscopy Surgery, National Institute of Sports Medicine, Beijing, China.

出版信息

Orthop Surg. 2021 Jun;13(4):1244-1253. doi: 10.1111/os.12998. Epub 2021 May 4.

Abstract

OBJECTIVE

To investigate the methods and outcomes of hip arthroscopy for hip labrum calcification, and to discuss the clinical, imaging, and intraoperative findings of hip labrum calcification.

METHODS

This is a therapeutic case series study. From January 2015 to June 2018, 15 patients who met the inclusion and exclusion criteria were followed up for at least 2 years for an analysis on the outcomes of arthroscopy in the treatment of hip labrum calcification and the clinical, imaging, and intraoperative findings of the patients. There were eight males and seven females, with an average age of 38.9 ± 8.8 years (range, 23-50 years). The visual analog scale (VAS), the modified Harris hip score (mHSS), and the international hip outcome tool (iHOT-12) were used to evaluate the outcomes of surgery.

RESULTS

A total of 15 patients were followed up for at least 2 years (28.1 ± 2.9 months). The average calcified volume was 118.0 mm (range, 19.4-609.2 mm ) and calcified volume was related to the preoperative hip function score. Thirteen patients had pain in the groin area (86.7%). Labrum calcifications were located (according to the clock distribution) as follows: 14 patients were anterior and superior (11:00-3:00); 12 cases of femoroacetabular impingement (FAI) were observed during operation, including five cases of pincer type, two cases of cam type, and five cases of mixed type. VAS pain score means were 7.73 ± 1.28 before surgery, decreasing to 2.0 ± 0.89 and 1.73 ± 0.79 at 1 and 2 years post-surgery, respectively. mHSS scores were 57.40 ± 6.23 before surgery and 82.10 ± 4.76 and 83.18 ± 4.07, 1 and 2 years post-surgery, respectively; iHOT-12 mean score pre-surgery was 37.67 ± 4.85, increasing to 67.64 ± 5.30 and 72.18 ± 4.49, 1 and 2 years post-surgery, respectively. Compared with preoperative values, postoperative VAS, mHSS, and iHOT-12 scores were significantly improved (P < 0.01); iHOT-12 scores also significantly decreased from 1 to 2 years postoperatively (P = 0.034). No patient had complications.

CONCLUSION

Hip arthroscopy is an effective method for the treatment of hip labrum calcification. The size of calcification influenced preoperative symptoms and function. Long-term irritation from FAI may be one important cause of labrum calcification.

摘要

目的

探讨髋关节镜治疗髋关节唇钙化的方法和疗效,并讨论髋关节唇钙化的临床、影像学和术中表现。

方法

这是一项治疗病例系列研究。2015 年 1 月至 2018 年 6 月,符合纳入和排除标准的 15 例患者接受了至少 2 年的随访,以分析髋关节镜治疗髋关节唇钙化的疗效以及患者的临床、影像学和术中表现。其中男性 8 例,女性 7 例,平均年龄 38.9±8.8 岁(范围,23-50 岁)。采用视觉模拟评分(VAS)、改良 Harris 髋关节评分(mHSS)和国际髋关节结局工具(iHOT-12)评估手术效果。

结果

15 例患者至少随访 2 年(28.1±2.9 个月)。钙化总体积为 118.0mm(范围,19.4-609.2mm),钙化体积与术前髋关节功能评分相关。13 例患者腹股沟区疼痛(86.7%)。根据时钟分布,髋关节唇钙化位于:14 例为前上(11:00-3:00);术中发现 12 例存在股骨髋臼撞击症(FAI),包括 5 例钳夹型、2 例凸轮型和 5 例混合型。术前 VAS 疼痛评分均值为 7.73±1.28,术后 1 年和 2 年分别降至 2.0±0.89 和 1.73±0.79。术前 mHSS 评分为 57.40±6.23,术后 1 年和 2 年分别为 82.10±4.76 和 83.18±4.07。术前 iHOT-12 平均评分为 37.67±4.85,术后 1 年和 2 年分别为 67.64±5.30 和 72.18±4.49。与术前相比,术后 VAS、mHSS 和 iHOT-12 评分均明显改善(P<0.01);术后 1 年至 2 年 iHOT-12 评分也明显下降(P=0.034)。无患者发生并发症。

结论

髋关节镜是治疗髋关节唇钙化的有效方法。钙化的大小影响术前症状和功能。FAI 的长期刺激可能是髋关节唇钙化的一个重要原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d540/8274186/5f364567ee8d/OS-13-1244-g007.jpg

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