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关节镜治疗青少年髋关节撞击综合征:系统评价和荟萃分析。

Arthroscopic Treatment for Femoroacetabular Impingement Syndrome in Adolescents: A Systematic Review and Meta-Analysis.

机构信息

Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing, China; and.

School of Clinical Medicine, Peking University Health Science Center, Beijing, China.

出版信息

Clin J Sport Med. 2022 Nov 1;32(6):608-616. doi: 10.1097/JSM.0000000000001053. Epub 2022 Jun 24.

Abstract

OBJECTIVE

The objective of this review was to analyze the effect of arthroscopic surgery for femoroacetabular impingement syndrome (FAI) in adolescents and factors that may influence the revision rate.

DESIGN

Systematic review and meta-analysis.

SETTING

PubMed, Scopus, Cochrane Library, EMBASE, and MEDLINE were searched from their earliest records to May 2021.

PATIENTS

Adolescents who underwent primary arthroscopic treatment for FAI.

INTERVENTIONS

Hip arthroscopic treatment.

MAIN OUTCOME MEASURES

Patient-reported outcomes (PROs), alpha angle, revision rates, and the rate of complications.

RESULTS

A total of 832 hips in 753 patients were included in this study. All PROs improved significantly. The modified Harris Hip Score pooled mean difference was 24.99 (95% CI, 22.88-27.10, P < 0.0001, I2 = 19.9%), Hip Outcome Score (HOS)-Sports-Specific Subscale was 35.88 (95% CI, 33.07-38.68, P < 0.0001, I2 = 0%), HOS-Activities of Daily Living was 23.53 (95% CI, 21.21-25.85, P < 0.0001, I2 = 0%), and the Nonarthritic Hip Score was 22.34 (95% CI, 18.40-26.28, P < 0.0001, I2 = 40.9%). The visual analog scale for pain decreased by 40.39 (44.39-36.40, P < 0.0001, I2 = 0%). The alpha angle decreased by 22.0 degrees from 62.9 degrees to 40.9 degrees after arthroscopic surgery. The rate of complication and revision surgery was 1.2% (10/832) and 3.4% (28/832), respectively, with high postoperative patient satisfaction.

CONCLUSIONS

All PROs significantly improved after surgery, with a low rate of complications and reoperation. High postoperative patient satisfaction was also reported.

摘要

目的

本综述的目的是分析髋关节镜手术治疗青少年髋关节撞击综合征(FAI)的效果,以及可能影响翻修率的因素。

设计

系统评价和荟萃分析。

设置

从最早记录开始,在 PubMed、Scopus、Cochrane 图书馆、EMBASE 和 MEDLINE 中搜索,直至 2021 年 5 月。

患者

接受髋关节镜初次治疗 FAI 的青少年。

干预措施

髋关节镜治疗。

主要观察指标

患者报告的结果(PROs)、α角、翻修率和并发症发生率。

结果

本研究共纳入 753 例患者的 832 髋。所有 PROs 均显著改善。改良 Harris 髋关节评分的合并均数差值为 24.99(95%CI,22.88-27.10,P<0.0001,I2=19.9%),髋关节评分(HOS)-运动专项量表为 35.88(95%CI,33.07-38.68,P<0.0001,I2=0%),HOS-日常生活活动量表为 23.53(95%CI,21.21-25.85,P<0.0001,I2=0%),非关节炎髋关节评分为 22.34(95%CI,18.40-26.28,P<0.0001,I2=40.9%)。视觉模拟评分疼痛降低 40.39(44.39-36.40,P<0.0001,I2=0%)。髋关节镜手术后,α角从 62.9 度降低至 40.9 度,减少 22.0 度。并发症和翻修手术的发生率分别为 1.2%(10/832)和 3.4%(28/832),术后患者满意度高。

结论

术后所有 PROs 均显著改善,并发症和再次手术率低,术后患者满意度高。

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