Arthroscopy. 2021 Jul;37(7):2137-2139. doi: 10.1016/j.arthro.2021.03.083.
The optimal classification system in arthroscopic and related surgery research and clinical practice should be clinically relevant, descriptive, reproducible, simple, inexpensive, safe, and widely applicable. For the hip, classification systems that characterize intra-articular disorders like femoroacetabular impingement (FAI) syndrome, dysplasia, labral tears, and articular cartilage disease predominate the literature. Recently, awareness of peritrochanteric and other extra-articular disorders has increasingly led to greater recognition, diagnosis, and treatment of what has been historically known as "just bursitis". These disorders are far more complex and include greater trochanteric pain syndrome, the spectrum of gluteal tendon pathology, greater trochanteric bursitis, snapping iliotibial band (external coxa saltans), and greater trochanteric-ischial impingement. The utility of an intraoperative greater trochanteric pain syndrome classification system has now been proven using prospectively collected data, assimilating a decade-long eligibility period following open or endoscopic treatment of peritrochanteric disorders with a minimum two-year follow-up using validated patient-reported outcome scores. This classification guides prognosis and treatment, exactly as an optimal orthopedic classification system should do.
在关节镜和相关手术研究及临床实践中,最佳的分类系统应该具有临床相关性、描述性、可重复性、简单、经济、安全和广泛适用性。对于髋关节,以描述性为主的分类系统主要用于研究髋关节内疾病,如股骨髋臼撞击(FAI)综合征、发育不良、盂唇撕裂和关节软骨疾病。最近,人们对髋关节周围和其他关节外疾病的认识不断提高,导致对历史上被称为“仅仅是滑囊炎”的疾病的诊断和治疗更加重视。这些疾病更为复杂,包括大转子疼痛综合征、臀肌腱病谱、大转子滑囊炎、髂胫束弹响(外部股骨跳跃)和大转子坐骨撞击。目前已经通过前瞻性收集的数据证明了术中大转子疼痛综合征分类系统的实用性,该系统整合了长达十年的髋关节周围疾病的开放性或内镜治疗的资格期,并使用经过验证的患者报告结局评分进行了至少两年的随访。该分类系统指导预后和治疗,正如最佳的骨科分类系统应该做的那样。