Kucharik Michael P, Abraham Paul F, Nazal Mark R, Varady Nathan H, Meek Wendy M, Martin Scott D
Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital / Harvard Medical School, Boston, Massachusetts, USA.
Department of Orthopaedic Surgery, University of Kentucky, Lexington, Kentucky, USA.
Am J Sports Med. 2021 Aug;49(10):2659-2667. doi: 10.1177/03635465211026666. Epub 2021 Jul 2.
There is a paucity of literature on arthroscopic capsular autograft labral reconstruction.
To report midterm functional outcomes for patients undergoing acetabular labral repair with capsular autograft labral reconstruction.
Case series; Level of evidence, 4.
This is a retrospective case series of prospectively collected data on patients who underwent arthroscopic acetabular labral repair by the senior surgeon between March 2013 and August 2018. The inclusion criteria for this study were adult patients aged 18 years or older who underwent primary hip arthroscopy for arthroscopic capsular autograft labral reconstruction. Exclusion criteria were <2 years of postoperative follow-up, elective disenrollment from study before 2-year follow-up, or repeat ipsilateral hip surgery before 2-year follow-up. Intraoperatively, patients underwent capsular autograft hip labral reconstruction if they were found to have a labrum with hypoplastic tissue (width <5 mm), complex tearing, or frank degeneration of native tissue. Clinical outcome data consisted of patient-reported outcome measures.
A total of 97 hips (94 patients) met the inclusion criteria with a mean final follow-up of 28.2 months (95% CI, 26.0-30.4). Patients had a mean age of 39.0 years (95% CI, 36.8-41.2) with a mean body mass index of 25.8 (95% CI, 24.9-26.7). When compared with baseline (40.4 [95% CI, 36.7-44.2]), the mean international Hip-Outcome Tool-33 (iHOT-33) scores were significantly greater at 3-month (60.9 [95% CI, 56.8-64.9]; < .001), 6-month (68.8 [95% CI, 64.7-72.9]; < .001), 12-month (73.2 [95% CI, 68.9-77.5]; < .001), and final (76.6 [95% CI, 72.4-80.8]; < .001) follow-up. At 2-year follow-up, 76.3%, 65.5%, and 60.8% of patients' iHOT-33 scores exceeded clinically meaningful outcome thresholds for minimally clinically important difference (MCID), patient-acceptable symptomatic state, and substantial clinical benefit, respectively.
In this study of 97 hips undergoing arthroscopic labral repair with capsular autograft labral reconstruction, we found favorable outcomes that exceeded the MCID thresholds in the majority of patients at a mean 28.2 months' follow-up. Future studies should compare outcomes between this technique and other methods of autograft and allograft reconstruction to determine differences in patient-reported outcomes, donor-site morbidity, and complications.
关于关节镜下自体囊盂唇重建的文献较少。
报告接受髋臼唇修复并进行自体囊盂唇重建患者的中期功能结果。
病例系列；证据等级，4级。
这是一项回顾性病例系列研究，前瞻性收集了2013年3月至2018年8月期间由资深外科医生进行关节镜下髋臼唇修复患者的数据。本研究的纳入标准为年龄18岁及以上的成年患者，因关节镜下自体囊盂唇重建接受初次髋关节镜检查。排除标准为术后随访时间不足2年、在2年随访前选择退出研究或在2年随访前同侧髋关节再次手术。术中，如果发现患者的盂唇有发育不全组织（宽度<5mm）、复杂撕裂或原生组织明显退变，则进行自体囊盂唇髋关节唇重建。临床结果数据包括患者报告的结局指标。
共有97例髋关节（94例患者）符合纳入标准，平均最终随访时间为28.2个月（95%CI，26.0 - 30.4）。患者平均年龄为39.0岁（95%CI，36.8 - 41.2），平均体重指数为25.8（95%CI，24.9 - 26.7）。与基线时（40.4[95%CI，36.7 - 44.2]）相比，在3个月（60.9[95%CI，56.8 - 64.9]；P <.001）、6个月（68.8[95%CI，64.7 - 72.9]；P <.001）、12个月（73.2[95%CI，68.9 - 77.5]；P <.001）和最终随访时（76.6[95%CI，72.4 - 80.8]；P <.001），国际髋关节结局工具-33（iHOT-33）的平均得分显著更高。在2年随访时，分别有76.3%、65.5%和60.8%的患者iHOT-33得分超过了最小临床重要差异（MCID）、患者可接受症状状态和显著临床获益的临床有意义结局阈值。
在这项对97例接受关节镜下唇修复并进行自体囊盂唇重建的髋关节研究中，我们发现平均随访28.2个月时，大多数患者的结果良好，超过了MCID阈值。未来的研究应比较该技术与其他自体移植和异体移植重建方法的结果，以确定患者报告结局、供区发病率和并发症方面的差异。
