Bech Niels H, van Dijk Lode A, de Waard Sheryl, Vuurberg Gwendolyn, Sierevelt Inger N, Kerkhoffs Gino Mmj, Haverkamp Daniël
Department of Orthopedic Surgery, Amsterdam University Medical Center, Amsterdam 1105 AZ, Netherlands.
Department of Orthopedic Surgery, Tergooi Ziekenhuis, Hilversum 1213 XZ, Netherlands.
World J Orthop. 2022 Apr 18;13(4):400-407. doi: 10.5312/wjo.v13.i4.400.
Current literature shows no clear answer on the question how to manage the capsule after hip arthroscopy. Regarding patient reported outcome measures there seems to be no difference between capsular repair or unrepaired capsulotomy.
To evaluate and compare the integrity of the hip capsule measured on a magnetic resonance imaging (MRI) scan after capsular repair or unrepaired capsulotomy.
A case series study was performed; a random sample of patients included in a trial comparing capsular repair unrepaired capsulotomy had a postoperative MRI scan. The presence of a capsular defect and gap size were independently evaluated on MRI.
A total of 28 patients (29 hips) were included. Patient demographics were comparable between treatment groups. There were 2 capsular defects in the capsular repair group and 7 capsular defects in the unrepaired capsulotomy group ( = 0.13). In the group of patients with a defect, median gap sizes at the acetabular side were 5.9 mm (range: 2.7-9.0) in the repaired and 8.0 mm (range: 4.5-18.0) in the unrepaired group ( = 0.462). At the muscular side gap sizes were 6.6 mm (range: 4.1-9.0) in the repaired group and 11.5 mm (range: 3.0-18.0) in the unrepaired group ( = 0.857). The calculated Odds ratio (OR) for having a capsular defect with an increasing lateral center-edge (CE) angle was 1.12 ( = 0.06). The OR for having a capsular defect is lower in the group of patients that underwent a labral repair with an OR of 0.1 ( = 0.05).
There is no significant difference in capsular defects between capsular repair or unrepaired capsulotomy. Regarding clinical characteristics our case series shows that a larger CE angle increases the likelihood of a capsular defect and the presence of a labral repair decreases the likelihood of a capsular defect.
当前文献对于髋关节镜检查后如何处理关节囊这一问题尚无明确答案。关于患者报告的结局指标，关节囊修复或未修复的关节囊切开术之间似乎没有差异。
评估并比较关节囊修复或未修复的关节囊切开术后，通过磁共振成像（MRI）扫描测量的髋关节囊完整性。
进行了一项病例系列研究；从一项比较关节囊修复与未修复的关节囊切开术的试验中随机抽取患者样本，进行术后MRI扫描。在MRI上独立评估关节囊缺损的存在情况和间隙大小。
共纳入28例患者（29髋）。各治疗组患者的人口统计学特征具有可比性。关节囊修复组有2例关节囊缺损，未修复的关节囊切开术组有7例关节囊缺损（P = 0.13）。在有缺损的患者组中，修复组髋臼侧的间隙大小中位数为5.9mm（范围：2.7 - 9.0），未修复组为8.0mm（范围：4.5 - 18.0）（P = 0.462）。在肌肉侧，修复组间隙大小为6.6mm（范围：4.1 - 9.0），未修复组为11.5mm（范围：3.0 - 18.0）（P = 0.857）。外侧中心边缘（CE）角增大时出现关节囊缺损的计算比值比（OR）为1.12（P = 0.06）。接受盂唇修复的患者组出现关节囊缺损的OR较低，为0.1（P = 0.05）。
关节囊修复或未修复的关节囊切开术之间在关节囊缺损方面无显著差异。关于临床特征，我们的病例系列表明，较大的CE角会增加关节囊缺损的可能性，而盂唇修复的存在会降低关节囊缺损的可能性。
