女性髋关节镜治疗股骨髋臼撞击症后显著改善。
Significant improvement after hip arthroscopy for femoroacetabular impingement in women.
机构信息
Hip Unit, Department of Orthopedic Surgery, HLA Clinica Vistahermosa, Av de Denia 76, 03016, Alicante, Spain.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2022 Jun;30(6):2181-2187. doi: 10.1007/s00167-021-06802-6. Epub 2021 Nov 27.
PURPOSE
This study was designed to evaluate outcomes in women after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) and compare these results with men.
METHODS
Retrospective study of a prospective database of patients undergoing hip arthroscopy between 2015 and 2018. Inclusion criteria were patients between 18 and 50 years of age, diagnosis of FAIS, complete clinical patient-reported outcomes (PROs), radiographic measurements, and underwent at least a 2-year HA follow-up. For each woman, two men underwent HA were matched in a 1:2 ratio based on age within 5 years, and date of surgery within 6 months. Diagnostic arthroscopy was performed to evaluate labral and chondral status. Radiographic evaluation, a self-administered Hip Outcome Score (HOS) questionnaire, with activity of daily living (ADL) and sports subscale (SSS), and a self-administered short version of the International Hip Outcome Tool (iHOT-12) were assessed at 6 months, 12 months, and then yearly. Clinical relevance was measured with the minimal clinical important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB) for HOS-ADL, HOS-SSS, and iHOT-12.
RESULTS
One hundred and eighty-five patients met the inclusion criteria. Fifty-two women were matched with 104 men. Significant differences in terms of demographics, radiographic results, intraoperative findings and arthroscopic procedures were found between women and men. Mean follow-up was 48.4 months in women and 50.2 months in men. Both groups showed significant improvement from preoperative PROs to the latest follow-up. There were no significant differences between groups in preoperative PROs, latest follow-up PROs and PROs improvements. The difference in frequency of patients achieving MCID, PASS, and SCB was only significant greater for iHOT-12 PASS in women compared with men.
CONCLUSION
Significant improvements in PROs in women after HA for FAIS at 4-year follow-up were found. Differences between women and men in PROs and rates of achieving MCID, SCB and PASS were only significant for iHOT-12 PASS.
LEVEL OF EVIDENCE
IV.
目的
本研究旨在评估髋关节镜检查（HA）治疗股骨髋臼撞击综合征（FAIS）后女性的治疗结果，并与男性进行比较。
方法
回顾性分析 2015 年至 2018 年期间接受髋关节镜检查的患者的前瞻性数据库。纳入标准为年龄在 18 至 50 岁之间的患者、FAIS 诊断、完整的临床患者报告结局（PRO）、影像学测量，并进行至少 2 年的 HA 随访。对于每位女性，根据年龄在 5 年内、手术日期在 6 个月内，匹配 2 名男性进行 HA。采用诊断性关节镜检查评估盂唇和软骨状况。影像学评估、髋关节结局评分（HOS）问卷（包括日常生活活动[ADL]和运动亚量表[SSS]）和国际髋关节结局工具（iHOT-12）的自我管理短版本在 6 个月、12 个月和随后的每年进行评估。临床相关性通过最小临床重要差异（MCID）、患者可接受的症状状态（PASS）和髋关节结局 ADL、髋关节结局 SSS 和 iHOT-12 的实质性临床获益（SCB）进行测量。
结果
185 名患者符合纳入标准。52 名女性与 104 名男性相匹配。女性与男性在人口统计学、影像学结果、术中发现和关节镜手术方面存在显著差异。女性平均随访 48.4 个月，男性平均随访 50.2 个月。两组患者的术前 PROs 与最新随访结果均有显著改善。两组患者术前 PROs、最新随访 PROs 和 PROs 改善情况无显著差异。只有女性 iHOT-12 PASS 的 MCID、PASS 和 SCB 发生率显著高于男性。
结论
髋关节镜治疗 FAIS 后 4 年随访时，女性的 PROs 显著改善。女性与男性在 PROs 以及 MCID、SCB 和 PASS 达标率方面的差异仅在 iHOT-12 PASS 方面有统计学意义。
证据水平
IV。
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