Owens Jade S, Jimenez Andrew E, Lee Michael S, Monahan Peter F, Maldonado David R, Domb Benjamin G
American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.
American Hip Institute Research Foundation, Chicago, Illinois, U.S.A; American Hip Institute, Chicago, Illinois, U.S.A.
Arthroscopy. 2023 Feb;39(2):271-282. doi: 10.1016/j.arthro.2022.08.023. Epub 2022 Aug 30.
(1) To report minimum 5-year patient-reported outcomes (PROs) and return to sport (RTS) rates in high-level athletes with borderline hip dysplasia (BHD) following primary hip arthroscopy for labral pathology and femoroacetabular impingement syndrome and (2) to compare results to a propensity-matched control group of athletes with normal acetabular coverage.
Data were reviewed for surgeries performed between February 2009 and February 2016. Patients were eligible if they underwent primary hip arthroscopy in the setting of BHD (lateral center-edge angle [LCEA] 18-25°) and competed in professional, collegiate, or high school sports. Inclusion criteria were preoperative and minimum 5-year follow-up scores for the modified Harris Hip Score (mHHS), Non-Arthritis Hip Score, Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale for pain. Rates of achieving the minimal clinically importance difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement satisfaction threshold (MOIST) were recorded in addition to RTS. BHD athletes were matched by age at the time of surgery, sex, body mass index, Tönnis grade, follow-up time, sport type, and competition level to a control group of 58 athletes with normal acetabular coverage (LCEA 25°-40°) for comparison.
A total of 34 BHD athletes were included with a mean follow-up of 73.6 ± 10.7 months. BHD athletes showed significant improvements in all PROs, demonstrated high RTS rates (90.0%), and achieved PASS/MCID/MOIST for mHHS (MCID: 80.0%, PASS: 93.3%, MOIST: 80.0%) and HOS-SSS (MCID: 76.7%, PASS: 73.3%) at high rates. When compared to a propensity-matched group with normal acetabular coverage, BHD athletes demonstrated similar postoperative PROs, rates of achieving psychometric thresholds, and RTS rates (P > .05). Additionally, by the latest follow-up, no athlete in either group required conversion to total hip arthroplasty.
High-level athletes with BHD undergoing primary hip arthroscopy for labral pathology and femoroacetabular impingement syndrome may expect favorable midterm outcomes and high RTS rates. These results were comparable to a control group of athletes with normal coverage.
Level III, retrospective cohort study.
（1）报告患有边缘性髋关节发育不良（BHD）的高水平运动员在因盂唇病变和股骨髋臼撞击综合征接受初次髋关节镜检查后至少5年的患者报告结局（PROs）和恢复运动（RTS）率，（2）将结果与髋臼覆盖正常的倾向匹配运动员对照组进行比较。
回顾2009年2月至2016年2月期间进行的手术数据。如果患者在BHD（外侧中心边缘角[LCEA]18 - 25°）情况下接受初次髋关节镜检查并参加职业、大学或高中体育比赛，则符合入选标准。纳入标准包括改良Harris髋关节评分（mHHS）、非关节炎髋关节评分、髋关节结局评分 - 运动特定子量表（HOS - SSS）的术前和至少5年随访评分以及疼痛视觉模拟量表。除RTS外，还记录达到最小临床重要差异（MCID）、患者可接受症状状态（PASS）和最大结局改善满意度阈值（MOIST）的比率。BHD运动员根据手术时年龄、性别、体重指数、Tönnis分级、随访时间、运动类型和比赛水平与58名髋臼覆盖正常（LCEA 25° - 40°）的运动员对照组进行匹配以作比较。
共纳入34名BHD运动员，平均随访73.6 ± 10.7个月。BHD运动员在所有PROs方面均有显著改善，显示出高RTS率（90.0%），并且在mHHS（MCID：80.0%，PASS：93.3%，MOIST：80.0%）和HOS - SSS（MCID：76.7%，PASS：73.3%）方面高比率地达到PASS/MCID/MOIST。与髋臼覆盖正常的倾向匹配组相比，BHD运动员术后PROs、达到心理测量阈值的比率和RTS率相似（P > 0.05）。此外，到最近一次随访时，两组中均无运动员需要转换为全髋关节置换术。
因盂唇病变和股骨髋臼撞击综合征接受初次髋关节镜检查的患有BHD的高水平运动员可能预期有良好的中期结局和高RTS率。这些结果与髋臼覆盖正常的运动员对照组相当。
III级，回顾性队列研究。
