髋关节镜治疗股骨髋臼撞击症的疗效是否随时间而改变？
Do the outcomes of hip arthroscopy for femoroacetabular impingement change over time?
机构信息
Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK.
Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK.
出版信息
Orthop Traumatol Surg Res. 2022 Jun;108(4):103157. doi: 10.1016/j.otsr.2021.103157. Epub 2021 Nov 29.
BACKGROUND
The purpose of this study was to search for changes in functional outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) between short and medium-term follow-up. Secondary aims included reporting rates of revision surgery and total hip arthroplasty (THA) at medium-term follow-up.
HYPOTHESIS
We hypothesised that patients' functional outcomes would improve between short and medium-term follow-up.
PATIENTS AND METHODS
Consecutive patients undergoing hip arthroscopy with a diagnosis of femoroacetabular impingement with labral tears between February 2013 and June 2015 were included. Twelve item international hip outcome tool (iHOT-12) and EuroQol 5D-5L (EQ-5D) scores were collected preoperatively, at short-term and medium-term follow-up. Short-term scores were recorded at a minimum of one year postoperatively and medium-term scores at a minimum of five years postoperatively. Survivorship was assessed with Kaplan-Meier analysis.
RESULTS
Short-term outcome data (at median follow-up 1.6 year, Interquartile range [IQR] 1-2.5) was available for 70 of 87 patients (80.5%) and medium-term outcome data (at median follow-up of 6.5 years, IQR 6-7.1) was available for 68 patients (78.2%). Median age at the time of surgery was 31 years (IQR 25-37). The median iHOT-12 scores at short and medium-term follow-up were 72 (IQR 48.75-91.25) and 85.8 (IQR 66.7-96.7) respectively (p<0.001). Medium-term survivorship was 91.2%. Survivorship following labral repair was 94.2%, and 81.3% following labral debridement (p=0.09).
DISCUSSION
Patients undergoing hip arthroscopy for FAI reported continued improvement in iHOT-12 scores between short and medium-term follow-up. Medium-term survivorship following FAI surgery may be greater when the labrum is repaired, although comparisons are limited by their differing indications. Conversion to THA was low with just 4 patients (4.6%) undergoing or being listed for THA at final follow-up.
LEVEL OF EVIDENCE
IV, Case series.
背景
本研究旨在探讨髋关节撞击症（FAI）患者接受髋关节镜术后短期和中期随访时功能结局的变化。次要目的包括报告中期随访时的翻修手术和全髋关节置换术（THA）的发生率。
假设
我们假设患者的功能结局将在短期和中期随访之间得到改善。
患者和方法
连续纳入 2013 年 2 月至 2015 年 6 月期间因髋关节撞击症伴盂唇撕裂接受髋关节镜手术的患者。术前、短期和中期随访时收集 12 项国际髋关节结果工具（iHOT-12）和欧洲五维健康量表 5 维简表（EQ-5D）评分。短期评分记录在术后至少 1 年，中期评分记录在术后至少 5 年。采用 Kaplan-Meier 分析评估生存率。
结果
70 例（80.5%）患者可获得短期随访（中位数随访时间为 1.6 年，IQR 1-2.5），68 例（78.2%）患者可获得中期随访（中位数随访时间为 6.5 年，IQR 6-7.1）。手术时的中位年龄为 31 岁（IQR 25-37）。短期和中期随访的 iHOT-12 评分中位数分别为 72（IQR 48.75-91.25）和 85.8（IQR 66.7-96.7）（p<0.001）。中期生存率为 91.2%。盂唇修复后的生存率为 94.2%，盂唇清创后的生存率为 81.3%（p=0.09）。
讨论
髋关节撞击症患者在短期和中期随访时报告 iHOT-12 评分持续改善。FAI 手术后，当盂唇修复时，中期生存率可能更高，尽管由于适应证不同，比较受到限制。最终随访时，只有 4 例（4.6%）患者接受或被列入 THA 手术。
证据等级
IV，病例系列研究。
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