Steadman Philippon Research Institute, Vail, Colorado, USA.
Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Am J Sports Med. 2022 Apr;50(5):1299-1305. doi: 10.1177/03635465221080162. Epub 2022 Mar 2.
Labral augmentation has emerged as an essential procedure to address a deficient or irreparable labrum while preserving native labral tissue and restoring the hip suction seal mechanism.
To evaluate midterm outcomes of arthroscopic hip labral augmentation for labral insufficiency after previous hip arthroscopy.
Case series; Level of evidence, 4.
Patients were identified from a prospectively collected database who underwent arthroscopic hip labral augmentation between January 2011 and January 2017 with a minimum 3-year follow-up. Pre- and postoperative patient-reported outcome scores were compared and included the 12-Item Short Form Health Survey physical and mental component summaries, Western Ontario and McMaster Universities Osteoarthritis Index, modified Harris Hip Score (mHHS), and Hip Outcome Score (HOS) (Activities of Daily Living [ADL] and Sport). Postoperative Tegner Activity Scale and patient satisfaction (1-10) scores were also evaluated. The minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) between the preoperative and minimum 3-year follow-up scores were calculated.
A total of 88 patients (39 men, 49 women) underwent revision hip arthroscopy with labral augmentation. The average age was 32.8 ± 11 years. Of these, 77 patients (88%) were available for the minimum 3-year follow-up. The survivorship (absence of conversion to total hip arthroplasty) at 3 years and 5 years was 93% at both time points, with a mean survival time of 8.5 years (95% CI, 8.0-8.9). Eleven patients (14%) required revision arthroscopic surgery for continued pain. Revisions occurred at a mean of 2.6 ± 1.4 years after augmentation. The mean follow-up was 5.2 ± 1.2 years (range, 3-9 years). For patients not requiring subsequent surgery (n = 61), all patient-reported outcome measures significantly improved, which included a 20-point increase in HOS-ADL (MCID, 82%; PASS, 72%) and mHHS (MCID, 78%; PASS, 70%). The median postoperative Tegner score was 4 (range, 1-10). The median postoperative patient satisfaction score was 9 out of 10 (range, 1-10).
Arthroscopic hip labral augmentation is a successful treatment option for patients with labral insufficiency after previous hip arthroscopy, demonstrating improved patient-reported outcomes and survivorship of 93% at 3 years and 5 years. This technique provides a valuable labral preservation option when addressing hip labral pathology when viable native labral tissue remains.
当存在有缺陷或不可修复的盂唇或需要保留原生盂唇组织并恢复髋关节抽吸密封机制时，盂唇增强术已成为一种重要的手术方法。
评估髋关节镜下盂唇增强术治疗髋关节镜检查后盂唇不全的中期结果。
病例系列；证据水平，4 级。
从 2011 年 1 月至 2017 年 1 月期间前瞻性收集数据库中确定了接受髋关节镜下盂唇增强术的患者，这些患者的随访时间至少为 3 年。比较了术前和术后患者报告的结果评分，包括 12 项简明健康调查量表的身体和精神成分总结、西部安大略省和麦克马斯特大学骨关节炎指数、改良 Harris 髋关节评分（mHHS）和髋关节评分（ADL 和运动）（HOS）。还评估了术后 Tegner 活动量表和患者满意度（1-10）评分。计算了术前和至少 3 年随访评分之间的最小临床重要差异（MCID）和可接受症状状态（PASS）。
共 88 例患者（39 例男性，49 例女性）接受了髋关节镜下盂唇增强术的翻修手术。平均年龄为 32.8 ± 11 岁。其中，77 例（88%）患者可获得至少 3 年的随访。3 年和 5 年的生存率（无转为全髋关节置换术）在两个时间点均为 93%，平均生存时间为 8.5 年（95%CI，8.0-8.9）。11 例（14%）患者因持续疼痛需要再次接受关节镜手术。增强后平均 2.6 ± 1.4 年进行翻修。平均随访时间为 5.2 ± 1.2 年（范围，3-9 年）。对于不需要后续手术的患者（n=61），所有患者报告的结果测量均显著改善，包括 HOS-ADL 增加 20 分（MCID，82%；PASS，72%）和 mHHS（MCID，78%；PASS，70%）。术后中位数 Tegner 评分为 4 分（范围，1-10）。术后中位数患者满意度评分为 10 分（范围，1-10）。
髋关节镜下盂唇增强术是髋关节镜检查后盂唇不全患者的一种成功治疗选择，可改善患者报告的结果，3 年和 5 年的生存率分别为 93%和 93%。当存在可行的原生盂唇组织时，该技术为治疗髋关节盂唇病变提供了一种有价值的盂唇保留选择。
