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保守治疗与髋关节撞击综合征(FAI)的关节镜手术治疗:系统评价和荟萃分析。

Conservative therapy versus arthroscopic surgery of femoroacetabular impingement syndrome (FAI): a systematic review and meta-analysis.

机构信息

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.

出版信息

J Orthop Surg Res. 2022 Jun 3;17(1):296. doi: 10.1186/s13018-022-03187-1.

Abstract

PURPOSE

FAI (femoroacetabular impingement syndrome) is a common cause of hip pain, resulting in a decreased life quality. This study aims to compare the postoperative clinical outcome between arthroscopic surgery (AT) and conservative treatment (CT).

METHOD

The six studies were selected from PubMed, Embase and OVID database. The data were extracted and analyzed by RevMan5.3. Mean differences and 95% confidence intervals were calculated. RevMan5.3 was used to assess the risk of bias.

RESULT

Six observational studies were assessed. The methodological quality of the trials indicated five of six studies had a low risk of bias and one article had a high risk of bias. The differences were statistically significant between AT and CT for HOS (follow-up for 6 months), iHOT-33 (follow-up for 6 months) improvement, iHOT-33 (follow-up for 12 months) improvement, iHOT-33 (follow-up for 12 months), EQ-5D-5L index score (follow-up for 12 months) and AT showed higher benefits than CT. Meanwhile no statistically significant were found in iHOT-33 (follow-up for 6 months), EQ-5D-5L index score (follow-up for 6 months), EQ5D-VAS (follow-up for 6 months) and EQ5D-VAS (follow-up for 12 months).

CONCLUSION

AT and CT both can have clinical effects when facing FAI. In our meta-analysis, hip arthroscopy is statistically superior to conservative treatment in both long-term and short-term effects.

摘要

目的

FAI(股骨髋臼撞击综合征)是导致髋关节疼痛和生活质量下降的常见原因。本研究旨在比较关节镜手术(AT)和保守治疗(CT)的术后临床疗效。

方法

从 PubMed、Embase 和 OVID 数据库中选择了 6 项研究。使用 RevMan5.3 提取和分析数据。计算平均值差异和 95%置信区间。使用 RevMan5.3 评估偏倚风险。

结果

评估了 6 项观察性研究。试验的方法学质量表明,6 项研究中有 5 项的偏倚风险较低,1 项的偏倚风险较高。在 HOS(随访 6 个月)、iHOT-33(随访 6 个月)改善、iHOT-33(随访 12 个月)改善、iHOT-33(随访 12 个月)、EQ-5D-5L 指数评分(随访 12 个月)方面,AT 与 CT 之间的差异具有统计学意义,AT 优于 CT。同时,在 iHOT-33(随访 6 个月)、EQ-5D-5L 指数评分(随访 6 个月)、EQ5D-VAS(随访 6 个月)和 EQ5D-VAS(随访 12 个月)方面,差异无统计学意义。

结论

FAI 患者接受 AT 和 CT 治疗均可获得临床疗效。在我们的荟萃分析中,关节镜在长期和短期疗效方面均优于保守治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0730/9166461/107b40405d27/13018_2022_3187_Fig1_HTML.jpg

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