Mortensen Alexander J, Tomasevich Kelly M, Ohlsen Suzanna M, O'Neill Dillon C, Featherall Joseph, Aoki Stephen K
Department of Orthopaedics, University of Utah, Salt Lake City, Utah, U.S.A.
School of Medicine, University of Utah, Salt Lake City, Utah, U.S.A.
Arthroscopy. 2022 May;38(5):1466-1477. doi: 10.1016/j.arthro.2021.09.021. Epub 2021 Sep 25.
To compare intraoperative hip joint distractibility between hips that previously underwent arthroscopic surgery and the contralateral hip with no history of surgical manipulation.
Patients undergoing revision hip arthroscopy between April 2019 and December 2020, who previously underwent arthroscopic hip surgery for femoroacetabular impingement syndrome, were prospectively enrolled. Exclusion criteria were any contralateral hip surgery. Before instrumentation, fluoroscopic images of both hips were obtained at 25 lbs traction intervals up to 100 lbs. Total joint space was measured at each traction interval. Distraction was calculated as the difference between the baseline joint space and the total joint space at each subsequent traction interval. Wilcoxon signed ranks tests and McNemar tests were used to compare distraction between revision and native contralateral hips.
Forty-seven patients were included. Mean distraction of operative hips was significantly greater than mean distraction of nonoperative hips at traction intervals of 50 lbs (2.13 vs 1.04 mm, P = .002), 75 lbs (6.39 vs 3.70 mm, P < .001), and 100 lbs (8.24 vs 5.39, P < .001). Mean total joint space of operative hips was significantly greater than mean total joint space of nonoperative hips at traction intervals of 50 lbs (6.60 vs 5.39 mm, P < .001), 75 lbs (10.86 vs 8.05 mm, P < .001), and 100 lbs (12.73 vs 9.73, P < .001). A greater percentage of operative hips achieved all distraction thresholds, in 2-mm intervals up to 10-mm, at each traction interval.
In the majority of patients undergoing revision hip arthroscopy, previous arthroscopic hip surgery increases axial distractibility of the hip joint compared with the native contralateral hip at axial traction forces of 50-100 lbs. Increased axial distractibility following hip arthroscopy may be suggestive of hip instability and can be assessed on a stress examination with the patient under anesthesia.
III, case-control study.
比较曾接受关节镜手术的髋关节与对侧无手术操作史的髋关节在术中的髋关节可牵张性。
前瞻性纳入2019年4月至2020年12月期间接受髋关节翻修关节镜手术的患者，这些患者此前因股骨髋臼撞击综合征接受过髋关节镜手术。排除标准为对侧髋关节有任何手术史。在器械操作前，以25磅的牵引间隔直至100磅获取双髋的透视图像。在每个牵引间隔测量总关节间隙。牵张度计算为基线关节间隙与每个后续牵引间隔时的总关节间隙之差。采用Wilcoxon符号秩检验和McNemar检验比较翻修髋关节与对侧未手术髋关节之间的牵张度。
纳入47例患者。在50磅（2.13对1.04毫米，P = 0.002）、75磅（6.39对3.70毫米，P < 0.001）和100磅（8.24对5.39，P < 0.001）的牵引间隔时，手术侧髋关节的平均牵张度显著大于非手术侧髋关节的平均牵张度。在50磅（6.60对5.39毫米，P < 0.001）、75磅（10.86对8.05毫米，P < 0.001）和100磅（12.73对9.73，P < 0.001）的牵引间隔时，手术侧髋关节的平均总关节间隙显著大于非手术侧髋关节的平均总关节间隙。在每个牵引间隔时，手术侧髋关节达到所有牵张阈值（以2毫米间隔直至10毫米）的百分比更高。
在大多数接受髋关节翻修关节镜手术的患者中，与对侧未手术髋关节相比，既往髋关节镜手术在50 - 100磅的轴向牵引力下增加了髋关节的轴向可牵张性。髋关节镜检查后轴向可牵张性增加可能提示髋关节不稳定，并且可以在患者麻醉下的应力检查中进行评估。
III，病例对照研究。
Zotero 插件