Tassinari Enrico, Mariotti Federica, Castagnini Francesco, Lucchini Stefano, Perdisa Francesco, Bracci Giovanni, Cosentino Monica, Bordini Barbara, Traina Francesco
Ortopedia-Traumatologia e Chirurgia Protesica e dei reimpianti di Anca e di Ginocchio, IrCCs Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy.
Laboratorio di Tecnologia Medica, IrCCs Istituto Ortopedico Rizzoli, Bologna, Italy.
J Exp Orthop. 2021 Dec 3;8(1):112. doi: 10.1186/s40634-021-00428-w.
The aim is to compare the results of isolated hip arthroscopy in patients with borderline dysplasia with Lateral center edge angle (LCEA) between 18° and 25° with a control group of patients with normal LCEA (> 25°).
Fifty hip arthroscopies performed in 45 patients were retrospectively evaluated. Exclusion criteria were: age > 40, hip arthritis > grade 2 according to Tonnis classification, femoral head avascular necrosis, pediatric's orthopaedics conditions and true dysplasia with LCEA < 18°.Two groups were identified: group A with 15 hips with LCEA between 25° and 18° and Group control B made of 35 hips with LCEA > 25°.
The groups were homogeneous for demography and pre-operative WOMAC and HOOS. Osteoplasty for CAM were performed in 100% of patients in both groups, only in 12 hips (34.4%) in group B we had both femoral and acetabular osteoplasty. Labral repair was performed in 86% of patients in group A, in 60% of patients in group B, capsular plication in 93% of group A, in 5% of case of group B. WOMAC and HOOS statically significant improved in both groups at final follow-up (24 months). No cases in both groups required conversion to total hip arthroplasty. Clinical outcomes of study group were comparable to the control group.
Even if the present small series is not conclusive, we suggest isolated arthroscopic management of patients with FAI and LCEA between 18° and 25°, but capsular plication and careful labral management are strongly recommended.
Level IV.
旨在比较外侧中心边缘角（LCEA）在18°至25°之间的临界发育不良患者行单纯髋关节镜检查的结果与LCEA正常（>25°）的对照组患者的结果。
回顾性评估45例患者所行的50例髋关节镜检查。排除标准为：年龄>40岁、根据托尼分类法髋关节关节炎>2级、股骨头缺血性坏死、小儿骨科疾病以及LCEA<18°的真性发育不良。确定了两组：A组有15例髋关节LCEA在25°至18°之间，对照组B组由35例髋关节LCEA>25°组成。
两组在人口统计学以及术前WOMAC和HOOS方面具有同质性。两组100%的患者均进行了凸轮成形术，仅B组的12例髋关节（34.4%）同时进行了股骨和髋臼成形术。A组86%的患者进行了盂唇修复，B组60%的患者进行了盂唇修复；A组93%的患者进行了关节囊折叠，B组5%的患者进行了关节囊折叠。末次随访（24个月）时两组的WOMAC和HOOS均有统计学意义的改善。两组均无病例需要转为全髋关节置换术。研究组的临床结果与对照组相当。
即使目前的小样本研究尚无定论，但我们建议对FAI且LCEA在18°至25°之间的患者行单纯关节镜治疗，但强烈建议进行关节囊折叠和仔细的盂唇处理。
IV级。
