Alvandi Bejan A, Dayton Steven R, Hartwell Matthew J, Gerlach Erik B, Swiatek Peter R, Carney John J, Tjong Vehniah K
Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Suite 1350, Chicago, IL, 60611, USA.
Curr Rev Musculoskelet Med. 2022 Oct;15(5):362-368. doi: 10.1007/s12178-022-09771-6. Epub 2022 Aug 2.
Femoracetabular impingement (FAI) is a common source of hip pain in children and adolescents. While nonoperative therapies and open surgical procedures can be effective, hip arthroscopy is a minimally invasive treatment option with substantial benefit. The purpose of this paper is to evaluate the current role of hip arthroscopy in treating FAI within the pediatric population. This article examines its efficacy through a review of hip arthroscopy outcomes in the contemporary orthopaedic literature.
Morphologic changes in the acetabulum and proximal femur seen in FAI can be attributed to a multitude of etiologies-including idiopathic FAI, Legg-Calve-Perthes, and slipped capital femoral epiphysis. In general, arthroscopic treatment of FAI secondary to these conditions leads to statistically significant improvements in pain and patient-reported outcomes in the short and long term. In the pediatric athlete, repetitive stress on the hip perpetuates FAI and can drastically hinder performance. Hip arthroscopy allows for a high rate of return to sport with minimal morbidity in this population. Overall, pediatric hip arthroscopy is effective in treating FAI secondary to a wide variety of conditions. Despite its clinical benefits, patients and their families should be counseled regarding alternative treatments, potential complications, and return to play.
股骨髋臼撞击症(FAI)是儿童和青少年髋关节疼痛的常见原因。虽然非手术治疗和开放手术可能有效,但髋关节镜检查是一种具有显著益处的微创治疗选择。本文旨在评估髋关节镜检查在治疗儿童FAI中的当前作用。本文通过回顾当代骨科文献中髋关节镜检查的结果来研究其疗效。
FAI中髋臼和股骨近端的形态学改变可归因于多种病因,包括特发性FAI、Legg-Calve-Perthes病和股骨头骨骺滑脱。一般来说,对这些疾病继发的FAI进行关节镜治疗在短期和长期内均可使疼痛和患者报告的结果在统计学上有显著改善。在儿童运动员中,髋关节反复受到应力会使FAI持续存在,并可能严重影响运动表现。髋关节镜检查使该人群能够以较低的发病率高比例重返运动。总体而言,儿童髋关节镜检查对治疗多种疾病继发的FAI有效。尽管其具有临床益处,但应向患者及其家属提供有关替代治疗、潜在并发症和重返运动的咨询。