Holleyman Richard James, Lyman Stephen, Bankes Marcus J K, Board Tim Nicholas, Conroy Jonathan Lee, McBryde Callum Wilson, Andrade Antonio Jose, Malviya Ajay, Khanduja Vikas
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Hospital for Special Surgery, New York, New York, USA.
Bone Jt Open. 2022 Apr;3(4):291-301. doi: 10.1302/2633-1462.34.BJO-2022-0003.R1.
This study uses prospective registry data to compare early patient outcomes following arthroscopic repair or debridement of the acetabular labrum.
Data on adult patients who underwent arthroscopic labral debridement or repair between 1 January 2012 and 31 July 2019 were extracted from the UK Non-Arthroplasty Hip Registry. Patients who underwent microfracture, osteophyte excision, or a concurrent extra-articular procedure were excluded. The EuroQol five-dimension (EQ-5D) and International Hip Outcome Tool 12 (iHOT-12) questionnaires were collected preoperatively and at six and 12 months post-operatively. Due to concerns over differential questionnaire non-response between the two groups, a combination of random sampling, propensity score matching, and pooled multivariable linear regression models were employed to compare iHOT-12 improvement.
A total of 2,025 labral debridements (55%) and 1,659 labral repairs (45%) were identified. Both groups saw significant (p < 0.001) EQ-5D and iHOT-12 gain compared to preoperative scores at 12 months (iHOT-12 improvement: labral repair = +28.7 (95% confidence interval (CI) 26.4 to 30.9), labral debridement = +24.7 (95% CI 22.5 to 27.0)), however there was no significant difference between procedures after multivariable modelling. Overall, 66% of cases achieved the minimum clinically important difference (MCID) and 48% achieved substantial clinical benefit at 12 months.
Both labral procedures were successful in significantly improving early functional outcome following hip arthroscopy, regardless of age or sex. Labral repair was associated with superior outcomes in univariable analysis, however there was no significant superiority demonstrated in the multivariable model. Level of evidence: III Cite this article: 2022;3(4):291-301.
本研究使用前瞻性注册数据比较髋臼盂唇关节镜修复或清创术后的早期患者预后。
从英国非关节置换髋关节注册中心提取2012年1月1日至2019年7月31日期间接受关节镜盂唇清创或修复的成年患者数据。排除接受微骨折、骨赘切除或同期关节外手术的患者。术前以及术后6个月和12个月收集欧洲五维健康量表(EQ-5D)和国际髋关节结局工具12(iHOT-12)问卷。由于担心两组之间问卷无应答存在差异,采用随机抽样、倾向评分匹配和合并多变量线性回归模型相结合的方法比较iHOT-12的改善情况。
共识别出2025例盂唇清创术(55%)和1659例盂唇修复术(45%)。与术前12个月的评分相比,两组的EQ-5D和iHOT-12均有显著提高(p < 0.001)(iHOT-12改善情况:盂唇修复= +28.7(95%置信区间(CI)26.4至30.9),盂唇清创= +24.7(95%CI 22.5至27.0)),然而多变量建模后两种手术之间无显著差异。总体而言,66%的病例在12个月时达到最小临床重要差异(MCID),48%的病例获得了实质性临床益处。
无论年龄或性别,两种盂唇手术均成功显著改善了髋关节镜检查后的早期功能结局。单变量分析中盂唇修复的结局更佳,然而多变量模型中未显示出显著优势。证据级别:III引用本文:2022;3(4):291-301。