髋关节镜治疗股骨髋臼撞击综合征显示出良好的疗效和较低的翻修率，年轻和术后疼痛评分低预示着5年的良好疗效。
Hip Arthroscopy for Femoroacetabular Impingement Syndrome Shows Good Outcomes and Low Revision Rates, With Young Age and Low Postoperative Pain Score Predicting Excellent 5-Year Outcomes.
作者信息
Huang Hong-Jie, Dang Han-Han, Mamtimin Mahmut, Yang Gang, Zhang Xin, Wang Jian-Quan
机构信息
Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China.
Peking University Health Science Center, Beijing, China.
出版信息
Arthroscopy. 2023 Feb;39(2):285-292. doi: 10.1016/j.arthro.2022.03.024. Epub 2022 Mar 31.
PURPOSE
To evaluate the clinical outcomes of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and their predictors at a minimum 5 years' follow-up.
METHODS
We retrospectively analyzed patients with FAIS after first-time unilateral hip arthroscopy between January 2010 and July 2016. Patient-reported outcomes (PROs) included the validated modified Harries Hip Score (mHHS) and Visual Analog Scale for Pain (Pain VAS). We included patients with Tönnis grade 0 or 1 and reported PROs, and excluded patients with previous hip diseases or bilateral symptoms. Bivariate and multivariate analyses were used for data analysis.
RESULTS
We included 159 patients with a mean follow-up of 6.4 years, aged 36.18 ± 8.61 years, 41.5% female, and a mean body mass index of 23.61 ± 3.45. The mean postoperative mHHS was 88.82 ± 11.60, and the mean Pain VAS was 1.93 ± 1.89, significantly better than before surgery (P < .001). Postoperative alpha angle (P = .003) and lateral center edge angle (P < .001) were significantly decreased. Most patients (83.7%) achieved clinically important improvement based on patient-acceptable symptom state and minimal clinically important difference (MCID). The overall revision surgery rate was 2.5%. There were no conversions to total hip arthroplasty. Bivariate analysis indicated that age (P < .001), preoperative mHHS (P = .002), and postoperative Pain VAS (P <.001) correlated with postoperative mHHS at a minimum 5 years' follow-up. Multivariate regression analysis of MCID showed that age (P <.001), preoperative PROs (P < .01 for both), and postoperative Pain VAS (P < .001) were significant outcome predictors.
CONCLUSION
Patients with FAIS after first-time unilateral hip arthroscopy showed significant improvement in PROs at mid-term follow-up, with a low revision surgery rate. Young patients and those with low postoperative Pain VAS showed excellent outcomes at a minimum 5 years' follow-up.
LEVEL OF EVIDENCE
Level IV, retrospective case series.
目的
评估髋关节镜治疗股骨髋臼撞击综合征（FAIS）的临床疗效及其在至少5年随访期内的预测因素。
方法
我们回顾性分析了2010年1月至2016年7月期间首次接受单侧髋关节镜手术治疗的FAIS患者。患者报告的结局指标（PROs）包括经过验证的改良哈里斯髋关节评分（mHHS）和视觉模拟疼痛量表（疼痛VAS）。我们纳入了Tönnis分级为0或1级且报告了PROs的患者，排除了既往有髋关节疾病或双侧症状的患者。采用双变量和多变量分析进行数据分析。
结果
我们纳入了159例患者，平均随访6.4年，年龄36.18±8.61岁，女性占41.5%，平均体重指数为23.61±3.45。术后平均mHHS为88.82±11.60，平均疼痛VAS为1.93±1.89，显著优于术前（P<.001）。术后α角（P=.003）和外侧中心边缘角（P<.001）显著减小。大多数患者（83.7%）基于患者可接受的症状状态和最小临床重要差异（MCID）实现了临床上重要的改善。总体翻修手术率为2.5%。没有转为全髋关节置换术的病例。双变量分析表明，年龄（P<.001）、术前mHHS（P=.002）和术后疼痛VAS（P<.001）与至少5年随访期后的术后mHHS相关。MCID的多变量回归分析显示，年龄（P<.001）、术前PROs（两者均P<.01）和术后疼痛VAS（P<.001）是显著的结局预测因素。
结论
首次单侧髋关节镜手术后的FAIS患者在中期随访时PROs有显著改善，翻修手术率较低。年轻患者和术后疼痛VAS较低的患者在至少5年随访期时显示出良好的结局。
证据水平
IV级回顾性病例系列。
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