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内镜治疗大转子疼痛综合征后良好的功能预后。

Good functional outcomes after endoscopic treatment for greater trochanteric pain syndrome.

作者信息

Karlsson Louise, Quist Philip, Helander Katarina Nilsson, Snaebjörnsson Thorkell, Stålman Anders, Lindman Ida, Öhlin Axel

机构信息

Department of Orthopedics, Sahlgrenska University Hospital Mölndal, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.

School of Medical Sciences, Örebro University, Örebro, Sweden.

出版信息

J Exp Orthop. 2023 Mar 15;10(1):26. doi: 10.1186/s40634-023-00574-3.

Abstract

PURPOSE

Greater trochanteric pain syndrome (GTPS) is a term covering different conditions generating lateral hip pain. Recalcitrant cases may require surgery but there are only a few studies evaluating endoscopic treatment. This study aimed to evaluate the outcome of endoscopically treated GTPS at minimum two years postoperatively using patient-reported outcome measures (PROMs), and to assess the complication rate associated with endoscopic surgery.

METHODS

A total of 33 patients, mean age 43.2 years, 88% women, with a mean symptom duration of 3.5 years, were included in the study. A total of 36 operated hips were included. Pre- and at minimum two years postoperatively the patients completed questionnaires consisting of the International Hip Outcome Tool (iHOT-12) and the Hip Sports Activity scale (HSAS), the Visual analogue scale for overall hip function (VAS-OHF), the Copenhagen Hip and Groin Outcome Score (HAGOS), the EuroQoL-5 Dimension Questionnaire (EQ-5D) and the EQ-VAS. Complications were assessed using the Clavien-Dindo classification.

RESULTS

Median follow-up time was 24.5 months postoperatively. Statistically significant improvements were seen for the following PROMs (p < 0.05); iHOT-12 (36.3 vs 54.0), HAGOS different subscores (40.8 vs 59.0, 46.5 vs 62.6, 29.9 vs 53.1, 33.5 vs 51.4, 20.7 vs 41.4, 23.4 vs 43.3), EQ-VAS (55.9 vs 63.3) and EQ-5D (0.392 vs 0.648). VAS-OHF and HSAS did not reach significance. There was a 71% satisfaction rate with the surgery. Three Clavien-Dindo grade 1 and one grade 2 complications were registered postoperatively, with 41% of patients achieving PASS for iHOT-12 at two years follow-up.

CONCLUSION

Endoscopic surgery for greater trochanteric pain syndrome improved patient-reported outcomes and the procedure was associated with low risk of complications.

LEVEL OF EVIDENCE

Level IV.

摘要

目的

大转子疼痛综合征(GTPS)是一个涵盖不同导致髋关节外侧疼痛病症的术语。顽固性病例可能需要手术治疗,但仅有少数研究评估内镜治疗效果。本研究旨在使用患者报告结局指标(PROMs)评估内镜治疗GTPS术后至少两年的疗效,并评估与内镜手术相关的并发症发生率。

方法

本研究共纳入33例患者,平均年龄43.2岁,88%为女性,平均症状持续时间3.5年。共纳入36个接受手术的髋关节。术前及术后至少两年,患者完成了由国际髋关节结局工具(iHOT-12)、髋关节运动活动量表(HSAS)、髋关节整体功能视觉模拟量表(VAS-OHF)、哥本哈根髋关节和腹股沟结局评分(HAGOS)、欧洲五维健康量表(EQ-5D)及EQ视觉模拟量表组成的问卷。使用Clavien-Dindo分类法评估并发症。

结果

术后中位随访时间为24.5个月。以下PROMs有统计学显著改善(p < 0.05);iHOT-12(36.3对54.0)、HAGOS不同子评分(40.8对59.0、46.5对62.6、29.9对53.1、33.5对51.4、20.7对41.4、23.4对43.3)、EQ视觉模拟量表(55.9对63.3)及EQ-5D(0.392对0.648)。VAS-OHF和HSAS未达显著差异。手术满意度为71%。术后记录到3例Clavien-Dindo 1级和1例2级并发症,41%的患者在两年随访时iHOT-12达到及格标准。

结论

内镜手术治疗大转子疼痛综合征改善了患者报告的结局,且该手术并发症风险较低。

证据级别

四级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55e6/10014635/d3ff8fe37002/40634_2023_574_Fig1_HTML.jpg

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