Gerry Adam S, Iturregui Jose M, Carlson Brian J, Hassebrock Jeffrey D, Christopher Zachary K, Spangehl Mark J, Economopoulos Kostas J, Bingham Joshua S
Midwestern University, AZCOM, Glendale, Arizona.
Department of Orthopedics, Mayo Clinic Arizona, Phoenix, Arizona.
Arthrosc Sports Med Rehabil. 2022 Dec 7;5(1):e103-e108. doi: 10.1016/j.asmr.2022.10.013. eCollection 2023 Feb.
To evaluate the rates of lateral femoral cutaneous nerve (LFCN) injury in patients who underwent a direct anterior approach (DAA) total hip arthroplasty (THA) with and without previous hip arthroscopy.
We retrospectively investigated consecutive DAA THAs performed by a single surgeon. These cases were grouped into patients with and without a history of previous ipsilateral hip arthroscopy. LFCN sensation was assessed during the initial follow-up (6 weeks) and 1-year (or most recent) follow-up visits. The incidence and character of LFCN injury was compared between the 2 groups.
In total, 166 patients underwent a DAA THA with no previous hip arthroscopy, and 13 had a history of previous arthroscopy. Of the 179 total patients who underwent THA, 77 experienced some form of LFCN injury at initial follow-up (43%). The rate of injury for the cohort with no previous arthroscopy was 39% (n = 65/166) on initial follow-up, whereas the rate of injury for the cohort with a history of previous ipsilateral arthroscopy was 92% (n =12/13) on initial follow-up ( < .001). In addition, although the difference was not significant, 28% (n = 46/166) of the group without history of previous arthroscopy and 69% (n = 9/13) of the group with a history of previous arthroscopy had continued symptoms of LFCN injury at most recent follow-up.
In this study, patients who underwent hip arthroscopy before an ipsilateral DAA THA were at increased risk of LFCN injury compared with patients who underwent a DAA THA without a previous hip arthroscopy. At final follow-up of patients with initial LFCN injury, symptoms resolved in 29% (n = 19/65) of patients with no previous hip arthroscopy and 25% (n = 3/12) of patients with previous hip arthroscopy.
Level III, case-control study.
评估接受或未接受过髋关节镜检查的患者在采用直接前路（DAA）全髋关节置换术（THA）时股外侧皮神经（LFCN）损伤的发生率。
我们回顾性研究了由单一外科医生连续进行的DAA THA病例。这些病例被分为有和没有同侧髋关节镜检查史的患者组。在初次随访（6周）和1年（或最近一次）随访时评估LFCN感觉。比较两组之间LFCN损伤的发生率和特征。
总共166例患者接受了DAA THA且之前未进行过髋关节镜检查，13例有髋关节镜检查史。在总共179例接受THA的患者中，77例在初次随访时出现某种形式的LFCN损伤（43%）。初次随访时，无髋关节镜检查史的队列损伤率为39%（n = 65/166），而有同侧髋关节镜检查史的队列损伤率为92%（n = 12/13）（P <.001）。此外，虽然差异不显著，但在最近一次随访时，无髋关节镜检查史组中有28%（n = 46/166）、有髋关节镜检查史组中有69%（n = 9/13）仍有LFCN损伤的持续症状。
在本研究中，与未接受过髋关节镜检查而接受DAA THA的患者相比，同侧DAA THA之前接受过髋关节镜检查的患者发生LFCN损伤的风险增加。在初次LFCN损伤患者的最终随访中，无髋关节镜检查史的患者中有29%（n = 19/65）、有髋关节镜检查史的患者中有25%（n = 3/12）症状得到缓解。
III级，病例对照研究。
