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 Jul;39(7):1702-1713. doi: 10.1016/j.arthro.2023.02.015. Epub 2023 Feb 22.
To systematically review and report the mid- to long-term patient-reported outcomes (PROs) after hip labral reconstruction.
A literature search of the PubMed, Embase, and Cochrane Library databases was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for clinical studies reporting mid- to long-term PROs at minimum 5-year follow-up after arthroscopic hip labral reconstruction. A quality assessment was performed using the Methodological Index of Non-Randomized Studies grading system. Data collection included study characteristics, demographics, indications, radiographic metrics, perioperative findings, surgical technique, baseline and most recent PROs, and subsequent surgeries.
Four studies met inclusion criteria, with 182 hips (age range, 27.9-38.7 years) undergoing labral reconstruction in primary and revision hip surgery with minimum 5-year follow-up. There were three Level III studies and one Level IV study, with an average Methodological Index of Non-Randomized Studies score of 16.6. All studies cited labral tissue characteristics as a factor for surgical indications, including the quality and/or size of the labrum. Three studies performed segmental labral reconstructions, whereas another study used a circumferential technique. Varying grafts were selected, including hamstring autograft/allograft, ligamentum teres autograft, iliotibial band autograft, and tensor fascia lata autograft. All studies demonstrated improved PROs from baseline to most recent follow-up, with 4 studies reporting modified Harris Hip Score values that increased from baseline (range, 58.9-66.8) to most recent follow-up (range, 80.1-86.3). After labral reconstruction, rates of revision arthroscopy ranged from 4.8% to 13.3% and conversion to total hip arthroplasty ranged from 1.6% to 27%.
Improved PROs were observed in all studies at minimum 5-year follow-up, suggesting that labral reconstruction can offer durable results beyond short-term follow-up. Although surgical indications for all studies included labral tissue characteristics, differing graft selection and surgical techniques were used across studies, limiting the ability to determine an optimal treatment approach.
Level IV, systematic review of Level III and IV studies.
系统回顾和报告髋关节盂唇重建术后的中期至长期患者报告结局（PROs）。
根据系统评价和荟萃分析报告临床研究的首选报告项目，对 PubMed、Embase 和 Cochrane 图书馆数据库进行文献检索，以报告至少 5 年的关节镜髋关节盂唇重建术后的中期至长期 PROs。使用非随机研究方法学指数评估质量。数据收集包括研究特征、人口统计学、适应证、影像学指标、围手术期发现、手术技术、基线和最近的 PROs 以及后续手术。
四项研究符合纳入标准，共 182 髋（年龄 27.9-38.7 岁）在初次和翻修髋关节手术中接受盂唇重建，随访时间至少 5 年。其中 3 项为 III 级研究，1 项为 IV 级研究，平均非随机研究方法学指数得分为 16.6。所有研究均将盂唇组织特征作为手术适应证的一个因素，包括盂唇的质量和/或大小。三项研究进行了节段性盂唇重建，另一项研究采用了环形技术。选择了不同的移植物，包括腘绳肌腱自体/同种异体移植物、圆韧带自体移植物、阔筋膜张肌自体移植物和阔筋膜张肌自体移植物。所有研究均显示从基线到最近随访时 PROs 得到改善，其中 4 项研究报告改良的 Harris 髋关节评分值从基线（范围 58.9-66.8）增加到最近随访（范围 80.1-86.3）。盂唇重建后，翻修关节镜检查的比例为 4.8%至 13.3%，转换为全髋关节置换术的比例为 1.6%至 27%。
在至少 5 年的随访中，所有研究均观察到 PROs 的改善，这表明盂唇重建可以提供短期随访以外的持久结果。尽管所有研究的手术适应证均包括盂唇组织特征，但不同的移植物选择和手术技术在研究中有所不同，限制了确定最佳治疗方法的能力。
IV 级，对 III 级和 IV 级研究的系统评价。
