Konnaris Maxwell A, Junginger Lucas M, Sibilsky Enselman Elizabeth R, Bell Richard D, Maerz Tristan, Bedi Asheesh
Hospital for Special Surgery, New York, NY, USA.
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
HSS J. 2023 Feb;19(1):97-106. doi: 10.1177/15563316221093614. Epub 2022 May 25.
Patients with symptomatic femoroacetabular impingement (FAI) have hip strength deficits, instability, and increased risk for concomitant injury. While surgical intervention is an effective method of treatment for FAI, more information is needed about the recovery process. : We sought to understand how patients with FAI recover from surgical correction in the short term. Do patients' perceptions of improvement correspond with measured improvements in hip strength? : We conducted a prospective cohort study of 17 patients (11 male, age range: 16-38 years) who were diagnosed with symptomatic FAI at a single surgeon's practice. Hip strength (flexion, extension, and abduction) was measured preoperatively and at 14, 26, and 52 weeks postoperatively. Patient-reported outcomes using the modified Harris Hip Score (mHHS) and Hip Outcome Osteoarthritis Score (HOOS) subscales were measured at the same time points and at 2 weeks postoperatively. : Compared with preoperative values, there was a significant increase in postoperative values at 26 and 52 weeks in normalized isokinetic hip extension (29% and 38%, respectively) and normalized hip abduction (48% and 55%, respectively). No differences in strength were observed at 14 weeks. Modified Harris Hip Score and all HOOS subscales were decreased by 2 weeks postoperatively, and by 14 weeks mHHS improved by 21%, and HOOS subscales improved as well (activities of daily living by 18%, pain by 34%, quality of life by 69%, sport and recreation by 36%, and symptoms by 28%). : We observed that patient-reported outcomes including symptoms, function, and satisfaction improved at 14 weeks, while objective measures of hip strength improved at 26 weeks following surgical correction of FAI. More rigorous study is indicated.
有症状的股骨髋臼撞击症（FAI）患者存在髋关节力量不足、不稳定以及并发损伤风险增加的问题。虽然手术干预是治疗FAI的有效方法，但对于恢复过程还需要更多信息。我们试图了解FAI患者在短期内如何从手术矫正中恢复。患者对改善的认知与髋关节力量的实际改善情况是否相符？我们对17例患者（11例男性，年龄范围：16 - 38岁）进行了一项前瞻性队列研究，这些患者在一位外科医生的诊所被诊断为有症状的FAI。术前以及术后14周、26周和52周测量髋关节力量（屈曲、伸展和外展）。同时在相同时间点以及术后2周使用改良Harris髋关节评分（mHHS）和髋关节结果骨关节炎评分（HOOS）子量表测量患者报告的结果。与术前值相比，术后26周和52周时，标准化等速髋关节伸展（分别为29%和38%）和标准化髋关节外展（分别为48%和55%）的术后值有显著增加。在14周时未观察到力量差异。术后2周时，改良Harris髋关节评分和所有HOOS子量表均下降，到14周时mHHS提高了21%，HOOS子量表也有所改善（日常生活活动提高18%，疼痛提高34%，生活质量提高69%，运动和娱乐提高36%，症状提高28%）。我们观察到，在FAI手术矫正后，患者报告的包括症状、功能和满意度等结果在14周时有所改善，而髋关节力量的客观测量在26周时有所改善。需要进行更严格的研究。
