Clinic for Orthopaedics, Traumatology and Sports Medicine, Klinikum Agnes Karll Laatzen/Klinikum Region Hannover, Hildesheimer Str. 158, 30880, Laatzen, Germany.
MVZ Jever, Orthopaedics and Trauma Surgery, Bahnhofstraße 1, Jever, Germany.
Arch Orthop Trauma Surg. 2023 May;143(5):2647-2652. doi: 10.1007/s00402-022-04561-8. Epub 2022 Sep 8.
As a result of increasing hip arthroscopies, rare pathologies as intra-articular amorphous calcium deposits in the capsule-labral (perilabral) recess can be recognized. There is a lack of publications on this pathology. The largest case series included 18 patients. An association between femoroacetabular impingement syndrome (FAIS) and female sex was observed. Furthermore, a correlation between the size of the calcific deposit and the preoperative hip function score was reported. Our hypothesis was that the data of our patient collective with intraoperative amorphous calcium deposits of the hip joint are comparable to the existing data to confirm previous observations.
From 01/2018 to 08/2020, a total of 714 hip arthroscopies were performed. 12 (1.7%) patients who presented intra-articular amorphous calcium deposits during arthroscopy were included. On radiographs, signs of impingement and osteoarthritis were determined. Characteristics and size of the calcific deposits were examined. Preoperative and at the time of follow-up (23 months), patient-reported outcome scores (PROS) were evaluated. Duration of symptoms, pain medication, comorbidities, and return-to-work were evaluated too.
The PROS of the four female and eight male patients improved significantly. The average size of the calcific deposit was 6.9 mm in the anteroposterior radiographs. Separation of the calcific deposit from the acetabular rim was seen in nine cases. No correlation between deposit sizes and PROS was found. Cam morphology was treated in ten cases. All patients returned to work after a median of 7 weeks (2.5-13 weeks).
Amorphous calcium deposits were found in approximately 1% of all hip joints with indication for hip arthroscopy. They are not consistently associated with gender, intra-articular hip pathologies or comorbidities. The clustered occurrence in cam FAI can be justified solely by the fact that impingement is by far the most common indication for hip arthroscopy.
随着髋关节镜检查的增加，在关节囊-盂唇（盂唇下）隐窝内可以识别出罕见的关节内无定形钙沉积等病理变化。关于这种病理变化的文献很少。最大的病例系列包括 18 名患者。观察到股骨髋臼撞击综合征（FAIS）与女性之间存在关联。此外，还报道了钙沉积物的大小与术前髋关节功能评分之间存在相关性。我们的假设是，我们的患者群体中髋关节关节内无定形钙沉积的资料与现有的数据具有可比性，可以证实以前的观察结果。
从 2018 年 1 月至 2020 年 8 月，共进行了 714 例髋关节镜检查。有 12 例（1.7%）患者在关节镜检查时发现关节内有无定形钙沉积。在 X 光片上，确定了撞击和骨关节炎的迹象。检查了钙沉积物的特征和大小。评估了术前和随访时（23 个月）的患者报告的结果评分（PROS）。还评估了症状持续时间、止痛药、合并症和重返工作岗位的情况。
四名女性和八名男性患者的 PROS 显著改善。在前后位 X 光片上，钙沉积物的平均大小为 6.9 毫米。在九例中可见钙沉积物与髋臼缘分离。未发现钙沉积物大小与 PROS 之间存在相关性。在十例中治疗了凸轮形态。所有患者的中位工作恢复时间为 7 周（2.5-13 周）。
在有髋关节镜检查指征的髋关节中，约有 1%的髋关节发现无定形钙沉积。它们与性别、关节内髋关节病变或合并症无一致关联。在凸轮 FAI 中，聚类发生仅可以归因于撞击是迄今为止髋关节镜检查最常见的指征。
