McCormack Thomas J, Vopat Matthew L, Rooker Jacob, Tarakemeh Armin, Baker Jordan, Templeton Kimberly J, Mulcahey Mary K, Mullen Scott M, Schroeppel John P, Vopat Bryan G
Medical Center, University of Kansas, Kansas City, Kansas, USA.
School of Medicine, Tulane University, New Orleans, Louisiana, USA.
Orthop J Sports Med. 2022 Nov 25;10(11):23259671221137857. doi: 10.1177/23259671221137857. eCollection 2022 Nov.
While sex-based differences in outcomes after hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) are often recorded, no studies have been dedicated to analyzing the literature as a whole.
To investigate whether sex is a predictor of outcomes in studies evaluating hip arthroscopic surgery for FAIS.
Systematic review; Level of evidence, 4.
A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched the PubMed, Embase, Cochrane, Ovid, and PubMed Central databases for English-language studies that evaluated sex-specific outcomes in human populations. The search terms used were as follows: ("Hip Arthroscopy") AND ("Femoroacetabular Impingement" OR "FAI") AND ("Sex" OR "Gender" OR "Male" OR "Female"). Studies with evidence levels 2 through 4 were included. The studies were then screened, followed by data extraction. Modified Harris Hip Score (mHHS) outcomes and return-to-sport (RTS) rates were recorded. These were analyzed using random-effects meta-analysis. Heterogeneity was calculated using the statistic.
Of 256 full-text articles screened, 48 articles were included in this analysis; of these, 14 studies (29%) concluded that female sex was a negative predictor of postoperative outcomes, while 6 studies (13%) found female sex to be positive predictor. The remaining 28 studies (58%) found no sex-based differences in postoperative outcomes. Of 7 studies (416 male and 519 female) included in the mHHS analysis, 2 studies concluded that male patients had significantly higher postoperative mHHS scores. Of 6 studies (502 male and 396 female) included in the RTS analysis, 1 study concluded that male patients had a significantly higher RTS rate.
Almost one-third of the included studies determined that female sex was a negative predictor of postoperative outcomes, 13% found female sex to be a positive predictor, and 58% found no sex-based differences. Our study illustrates an insufficiency of high-level evidence supporting sex-specific differences in outcomes after hip arthroscopic surgery, but findings indicated that the postoperative mHHS score and RTS rate may be influenced by sex.
虽然在针对股骨髋臼撞击综合征（FAIS）进行髋关节镜手术后的结果中，基于性别的差异经常被记录，但尚未有研究致力于对整体文献进行分析。
探讨在评估针对FAIS进行髋关节镜手术的研究中，性别是否为结果的预测因素。
系统评价；证据等级，4级。
按照PRISMA（系统评价和Meta分析的首选报告项目）指南进行系统评价。我们在PubMed、Embase、Cochrane、Ovid和PubMed Central数据库中检索了评估人群中性别特异性结果的英文研究。使用的检索词如下：（“髋关节镜检查”） AND （“股骨髋臼撞击”或“FAI”） AND （“性别”或“性别差异”或“男性”或“女性”）。纳入证据等级为2至4级的研究。然后对研究进行筛选，接着进行数据提取。记录改良Harris髋关节评分（mHHS）结果和恢复运动（RTS）率。使用随机效应Meta分析对这些进行分析。使用 统计量计算异质性。
在筛选的256篇全文文章中，本分析纳入了48篇文章；其中，14项研究（29%）得出结论，女性是术后结果的负性预测因素，而6项研究（13%）发现女性是正性预测因素。其余28项研究（58%）未发现术后结果存在基于性别的差异。在纳入mHHS分析的7项研究（416名男性和519名女性）中，2项研究得出结论，男性患者术后mHHS评分显著更高。在纳入RTS分析的6项研究（502名男性和396名女性）中，1项研究得出结论，男性患者的RTS率显著更高。
几乎三分之一的纳入研究确定女性是术后结果的负性预测因素，13%发现女性是正性预测因素，58%未发现基于性别的差异。我们的研究表明，支持髋关节镜手术后结果存在性别特异性差异的高级别证据不足，但研究结果表明术后mHHS评分和RTS率可能受性别影响。
