Röling Maarten A, Hesseling Brechtje, Mathijssen Nina M C, Bloem Rolf M
Department of Orthopaedic Surgery, Gelre Hospital Apeldoorn, Apeldoorn, The Netherlands.
Department of Orthopaedic Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands.
Arthrosc Sports Med Rehabil. 2021 Aug 24;3(5):e1481-e1490. doi: 10.1016/j.asmr.2021.06.014. eCollection 2021 Oct.
To analyze whether subgroups of patients could be distinguished with different functional recovery trajectories after hip arthroscopy for femoroacetabular impingement (FAI) syndrome and to identify differences between those subgroups using data from our prospective cohort registration.
We retrospectively reviewed the prospectively registered data of patients who had undergone hip arthroscopy for FAI syndrome in our clinic from 2015 through 2018. Latent class growth modeling and growth mixture modeling were used to identify and classify groups of patients according to the trajectory of functional recovery using the Hip Outcome Score-Activities of Daily Life (HOS-ADL). We used univariable analysis and descriptive statistics to explore whether differences in group membership could be identified.
A total of 100 patients were analyzed. Growth mixture modeling identified 2 main types of recovery pattern after surgery: patients in whom the HOS-ADL improved significantly after surgery to 90, whom we called the "improvers" (with fast initial improvement within 3 months that is maintained during follow-up), and patients who did not significantly benefit from surgery (with only mild improvement in the HOS-ADL at 3 months and no further change during follow-up), whom we called the "non-improvers." Univariable analysis and comparison of differences between subgroups showed higher preoperative visual analog scale scores for pain and more intraoperative arthrosis of the femoral head for the non-improvers.
We identified 2 main types of recovery pattern after arthroscopic treatment of FAI syndrome: improvers and non-improvers. Both groups recover in a different manner postoperatively. Preoperative pain and intraoperative arthrosis of the femoral head differed in the non-improvers compared with the improvers.
Level III, retrospective cohort study.
分析股骨髋臼撞击症（FAI）综合征行髋关节镜手术后，能否区分出具有不同功能恢复轨迹的患者亚组，并利用我们前瞻性队列登记的数据确定这些亚组之间的差异。
我们回顾性分析了2015年至2018年在我院因FAI综合征接受髋关节镜手术患者的前瞻性登记数据。使用潜在类别增长模型和增长混合模型，根据使用髋关节功能评分-日常生活活动（HOS-ADL）的功能恢复轨迹来识别和分类患者组。我们使用单变量分析和描述性统计来探索是否能识别出组间差异。
共分析了100例患者。增长混合模型确定了术后2种主要的恢复模式：术后HOS-ADL显著改善至90分的患者，我们称之为“改善者”（术后3个月内初始改善迅速且在随访期间保持），以及未从手术中显著获益的患者（术后3个月HOS-ADL仅轻度改善且随访期间无进一步变化），我们称之为“未改善者”。亚组间的单变量分析和差异比较显示，未改善者术前疼痛视觉模拟量表评分更高，术中股骨头关节病更多。
我们确定了FAI综合征关节镜治疗后2种主要的恢复模式：改善者和未改善者。两组术后恢复方式不同。与改善者相比，未改善者术前疼痛和术中股骨头关节病存在差异。
III级，回顾性队列研究。
