Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.
Orthop Surg. 2021 Aug;13(6):1835-1842. doi: 10.1111/os.13042.
To retrospectively assess the mid-term clinical and radiological results of hip arthroscopic treatment of labral tears in patients with borderline developmental dysplasia of the hip (BDDH).
From January 2010 and December 2019, data were retrospectively reviewed for all patients who underwent arthroscopic surgery of the hip for the treatment of intra-articular abnormalities. Only the Patients who had borderline developmental dysplasia (BDDH) were included. All operations were performed by two senior surgeons, the arthroscopic treatment including labral repair, labral debridement, minimal acetabuloplasty, femoroplasty and capsular closure. The evaluation consisted of pain evaluation (visual analog scale [VAS]), the modified Harris hip score (MHHS), range of motion, the radiological evaluation of plain film and MRI analysis of the hip joint. The plain film evaluation included anteroposterior views of the pelvis to assess lateral center-edge angle (LCEA) and acetabular inclination (AI), frog-leg lateral views of the hip to assess α angle.
There were 34 patients (36 hips) ultimately enrolled in this study. The follow-up duration of the patients were minimal 2 years (average, 69.2 months) postoperatively. The patient group included seven men and 27 women, the mean age at the time of surgery was 30.9 years. The mean BMI was 22.3 kg/m . From the pre-operative status to the final follow-up visit, mean mHHS score increased from 64.5 to 92.7, mean VAS score decreased from 6.8 to 1.3. All scores exhibited statistically significant differences (P < 0.001). The mean LCEA decreased from 22.9° to 22.7°, the mean AI decreased from 7.7° to 7.6°. Which all showed no significant differences compared with the final follow-up to the pre-operative status (P > 0.05). However, the mean α angle was significantly decreased from 48.3° to 40.1° (P < 0.001). We encountered no significant complications such as infection, deep venous thrombosis, fluid extravasation, or permanent nerve injury. One patient (2.94%) underwent revision periacetabular osteotomies (PAO) because of subluxation of the hip joint with permanent pain after 6 months failed conservative treatment.
Arthroscopic treatment of labral tears in patients with BDDH may provide safe and durable favorable results at midterm follow-up. The best outcome could be expected in patients with labral repair and closure of the capsule with strict patient selection criteria.
回顾性评估髋关节镜治疗边缘型发育性髋关节发育不良（BDDH）患者盂唇撕裂的中期临床和影像学结果。
从 2010 年 1 月至 2019 年 12 月，对所有接受髋关节镜手术治疗关节内异常的患者进行回顾性数据分析。仅纳入存在边缘型发育性髋关节发育不良（BDDH）的患者。所有手术均由两位资深外科医生完成，关节镜治疗包括盂唇修复、盂唇清创、最小程度的髋臼成形术、股骨成形术和囊闭术。评估包括疼痛评估（视觉模拟评分 [VAS]）、改良 Harris 髋关节评分（MHHS）、活动范围、髋关节的 X 线平片和 MRI 分析。X 线平片评估包括骨盆前后位片以评估外侧中心边缘角（LCEA）和髋臼倾斜角（AI），蛙式侧位片评估 α 角。
本研究最终纳入 34 名患者（36 髋）。患者的随访时间至少为术后 2 年（平均 69.2 个月）。患者组包括 7 名男性和 27 名女性，手术时的平均年龄为 30.9 岁。平均 BMI 为 22.3kg/m 2 。从术前状态到最终随访，平均 mHHS 评分从 64.5 增加到 92.7，平均 VAS 评分从 6.8 降低到 1.3。所有评分均有统计学差异（P<0.001）。平均 LCEA 从 22.9°降至 22.7°，平均 AI 从 7.7°降至 7.6°。与术前相比，这些变化均无统计学意义（P>0.05）。然而，平均 α 角从 48.3°显著降至 40.1°（P<0.001）。我们未发现感染、深静脉血栓形成、液体渗出或永久性神经损伤等严重并发症。1 名患者（2.94%）因髋关节半脱位伴永久性疼痛而接受了髋臼周围截骨术（PAO）翻修，该患者在 6 个月后保守治疗失败。
髋关节镜治疗边缘型发育性髋关节发育不良患者的盂唇撕裂可能在中期随访中提供安全且持久的良好结果。对于严格选择患者的盂唇修复和囊闭的患者，可获得最佳疗效。
