Dong H M, Wu R Q, Gao G Y, Liu R G, Xu Y
Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Oct 18;53(5):1007-1011. doi: 10.19723/j.issn.1671-167X.2021.05.033.
To investigate the surgical effect of hip arthroscopic labrum reconstruction. A retrospective study was performed on the clinical data of 12 patients who underwent hip arthroscopic labrum reconstruction in our department from September 2017 to February 2021 and were followed up for 5-46 months, with an average of 21.5 months. All the patients had a hip joint space of more than 2 mm, and Tonnis grade less than level Ⅱ. These 12 patients underwent arthroscopic debridement of hyperplastic synovium, femoral head and neck and/or acetabular osteoplasty, and labrum reconstruction using autograft iliotibial band or gracilis tendon. After the surgery, we conducted follow-up and data collection, recorded the satisfaction of the patients and occurrence of complications, as well as the cartilage lesion of hip joint observed under the arthroscopy. We compared the alpha angle of Dunn X-ray film, center-edge angle (CE angle) of AP X-ray film, modified Harris hip score (mHHS score), hip outcome score (HOS), international hip outcome tool 12 score (iHOT12 Score), and visual analogue scale (VAS scale) before and after the arthroscopic operation, to assess clinical symptom relief and joint function recovery. The 12 patients were followed up for 5-46 (21.5±12.8) months. The VAS scale were (5.3±2.5) and (2.5±1.4) before and after the surgery, showing significant decrease (=0.018). The mHHS score were (60.6±22.2) and (83.1±5.8) before and after the surgery, showing significant increase (=0.003). The patient satisfaction was high (7.8±2.0) (range: 0-10). None of the 12 patients had serious complications, revision surgery, or total hip replacement at the end of the last follow-up. Autologous tendon transplantation for reconstruction of acetabular labrum under arthroscopy can improve the clinical symptoms and joint function of patients with femoroacetabular impingement (FAI), which is a safe and effective treatment.
探讨髋关节镜下盂唇重建的手术效果。对2017年9月至2021年2月在我科接受髋关节镜下盂唇重建的12例患者的临床资料进行回顾性研究,随访时间为5 - 46个月,平均21.5个月。所有患者髋关节间隙均大于2mm,Tonnis分级小于Ⅱ级。这12例患者均接受了增生滑膜、股骨头和颈部的关节镜清理及/或髋臼成形术,并采用自体髂胫束或股薄肌腱进行盂唇重建。术后进行随访和数据收集,记录患者的满意度、并发症发生情况以及关节镜下观察到的髋关节软骨损伤情况。比较关节镜手术前后Dunn X线片的α角、前后位X线片的中心边缘角(CE角)、改良Harris髋关节评分(mHHS评分)、髋关节结果评分(HOS)、国际髋关节结果工具12评分(iHOT12评分)以及视觉模拟量表(VAS量表),以评估临床症状缓解情况和关节功能恢复情况。12例患者随访5 - 46(21.5±12.8)个月。术前、术后VAS量表评分分别为(5.3±2.5)和(2.5±1.4),差异有统计学意义(=0.018)。术前、术后mHHS评分分别为(60.6±22.2)和(83.1±5.8),差异有统计学意义(=0.003)。患者满意度较高(7.8±2.0)(范围:0 - 10)。在最后一次随访结束时,12例患者均未出现严重并发症、翻修手术或全髋关节置换。关节镜下自体肌腱移植重建髋臼盂唇可改善股骨髋臼撞击症(FAI)患者的临床症状和关节功能,是一种安全有效的治疗方法。