American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
American Hip Institute, Des Plaines, Illinois, USA.
Am J Sports Med. 2022 Sep;50(11):2998-3008. doi: 10.1177/03635465221108955. Epub 2022 Jul 25.
Bilateral hip symptoms from femoroacetabular impingement syndrome (FAIS) are a common finding in patients regardless of athletic involvement. Oftentimes, patients and surgeons choose to stage bilateral hip arthroscopic surgery.
PURPOSE/HYPOTHESIS: The purpose of this study was (1) to compare minimum 2-year outcomes between patients who underwent staged bilateral hip arthroscopic surgery for FAIS to a propensity score-matched control group that underwent unilateral hip arthroscopic surgery and (2) to investigate the effect of time between bilateral procedures on patient-reported outcomes (PROs). We hypothesized that, after bilateral hip arthroscopic surgery, the improvement in outcomes would be similar to that after unilateral hip arthroscopic surgery and the time duration between bilateral procedures would not affect the final outcome.
Cohort study; Level of evidence, 3.
Data were retrospectively reviewed on a consecutive series of patients who underwent primary hip arthroscopic surgery at our institution between June 2008 and November 2017. Patients who underwent bilateral hip arthroscopic surgery with minimum 2-year PROs for the modified Harris Hip Score (mHHS), the Nonarthritic Hip Score (NAHS), the Hip Outcome Score-Sports Specific Subscale (HOS-SSS), patient satisfaction, and a visual analog scale (VAS) for pain were included. The study group was matched 1:1 based on age, sex, and body mass index to a control group that only required unilateral hip arthroscopic surgery. Additionally, a subanalysis was performed on the study group to determine the effect of time between arthroscopic procedures. Rates of achieving the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) for the mHHS and HOS-SSS were determined. The value was set at <.05.
A total of 205 patients (410 hips) were included. The mean age and body mass index of the study group were 32.3 ± 13.2 years and 25.0 ± 5.1, respectively. All 410 hips that met the inclusion criteria were matched. There were no significant differences in patient, radiographic, or procedural data. A significant and comparable improvement was reported for all PRO measures and the VAS ( < .0001) in both groups. Similarly, rates of achieving the MCID and PASS were comparable. After dividing the study group based on whether the contralateral procedure was performed <3 months or >3 months after the first procedure, it was determined that patients had a significant improvement and favorable outcomes regardless of time between bilateral procedures.
Patients who underwent unilateral and bilateral hip arthroscopic surgery for FAIS had a significant and comparable improvement in PROs at a minimum 2-year follow-up. A time interval of <3 months or >3 months between bilateral procedures did not affect PROs.
患有股骨髋臼撞击综合征（FAIS）的患者双侧髋关节均有症状，这是一种常见现象，无论是否有运动参与。通常，患者和外科医生会选择分期双侧髋关节镜手术。
目的/假设：本研究的目的是：（1）比较分期双侧髋关节镜手术治疗 FAIS 的患者与单侧髋关节镜手术的倾向评分匹配对照组的至少 2 年结果；（2）研究双侧手术之间的时间间隔对患者报告的结果（PRO）的影响。我们假设，双侧髋关节镜手术后，结果的改善将与单侧髋关节镜手术后相似，并且双侧手术之间的时间间隔不会影响最终结果。
队列研究；证据水平，3 级。
对 2008 年 6 月至 2017 年 11 月期间在我院接受初次髋关节镜手术的连续患者系列进行回顾性数据分析。纳入至少有 2 年改良 Harris 髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）、髋关节结局评分-运动特异性亚量表（HOS-SSS）、患者满意度和疼痛视觉模拟评分（VAS）的接受双侧髋关节镜手术且 PRO 随访的患者。根据年龄、性别和体重指数，将研究组与仅需要单侧髋关节镜手术的对照组 1:1 匹配。此外，对研究组进行了亚分析，以确定关节镜手术之间的时间间隔的影响。确定 mHHS 和 HOS-SSS 的最小临床重要差异（MCID）和患者可接受症状状态（PASS）的达标率。设定 值<.05。
共纳入 205 例患者（410 髋）。研究组的平均年龄和体重指数分别为 32.3 ± 13.2 岁和 25.0 ± 5.1。所有符合纳入标准的 410 髋均进行了匹配。两组患者、影像学和手术数据均无显著差异。两组患者的所有 PRO 测量和 VAS 评分均有显著且相似的改善（<.0001）。同样，MCID 和 PASS 的达标率也相似。根据第一次手术后 3 个月内或 3 个月后是否进行对侧手术，将研究组分为两组，结果发现无论双侧手术之间的时间间隔如何，患者均有显著改善且预后良好。
接受单侧和双侧髋关节镜手术治疗 FAIS 的患者在至少 2 年的随访中，PRO 均有显著且相似的改善。双侧手术之间的时间间隔<3 个月或>3 个月不会影响 PRO。
