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[无透视髋关节镜技术治疗股骨髋臼撞击综合征的疗效]

[Outcomes of fluoroscopy-free hip arthroscopy technique in the treatment of femoroacetabular impingement syndrome].

作者信息

Wang M X, Wang Y T, Wang L, Zhang J, An M Y, Wu Y D, Yu K K, He H Y, Li C B

机构信息

Department of Orthopedics, the No.4 Medical Centre, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2023 Mar 21;103(11):809-815. doi: 10.3760/cma.j.cn112137-20220912-01928.

Abstract

To evaluate the effect of fluoroscopy-free technique in the arthroscopic treatment of femoroacetabular impingement syndrome (FAIS). A retrospective cohort study. Clinical data of FAI patients treated with hip arthroscopy in the No.4 Medical Center, PLA General Hospital from October 2018 to December 2021 were retrospectively analyzed. The patients were divided into two groups according to the surgical procedure: the fluoroscopy group and the fluoroscopy-free group. The operation time and modified Harris hip score (mHHS), international hip outcome tool (iHOT12) and visual analogue scale (VAS) of hip joint pain before and after the operation were observed and compared between the two groups. And the incidence of surgical complications in the two groups were compared too. A total of 460 patients (213 males and 247 females) [aged (32.6±8.3) years (15-67 years)] with valid follow-up were included in this study. There were 275 cases in the fluoroscopy-free group and 185 cases in the fluoroscopy group. The operation time was shorter in the fluoroscopy-free group when compared with that in the fluoroscopy group, and the difference was statistically significant [(93.36±12.54) min vs (115.62±6.03) min, <0.001]. In both groups, the VAS scores decreased and the mHHS scores and iHOT12 scores improved significantly at the last follow-up when compared with those before the operation (all <0.001); however, there was no significant difference in the scores between the two groups (all >0.05). The complication rate in the fluoroscopy-free group was 10.18% (28/275), and it was 10.81%(20/185) in the fluoroscopy group (=0.829). Fluoroscopy-free hip arthroscopy technique for FAI can avoid radiation and shorten the operation time, but it does not increase the incidence of complications with reliable clinical outcomes.

摘要

评估无透视技术在关节镜治疗股骨髋臼撞击综合征(FAIS)中的效果。一项回顾性队列研究。回顾性分析2018年10月至2021年12月解放军总医院第四医学中心接受髋关节镜治疗的FAI患者的临床资料。根据手术方式将患者分为两组:透视组和无透视组。观察并比较两组患者的手术时间、改良Harris髋关节评分(mHHS)、国际髋关节疗效工具(iHOT12)以及术前和术后髋关节疼痛视觉模拟量表(VAS)。同时比较两组手术并发症的发生率。本研究共纳入460例有有效随访的患者(男性213例,女性247例),年龄(32.6±8.3)岁(15 - 67岁)。无透视组275例,透视组185例。无透视组的手术时间短于透视组,差异有统计学意义[(93.36±12.54)分钟 vs (115.62±6.03)分钟,<0.001]。两组患者末次随访时的VAS评分均降低,mHHS评分和iHOT12评分均较术前显著改善(均<0.001);然而,两组评分之间差异无统计学意义(均>0.05)。无透视组并发症发生率为10.18%(28/275),透视组为10.81%(20/185)(=0.829)。用于FAI的无透视髋关节镜技术可避免辐射并缩短手术时间,但不增加并发症发生率,临床疗效可靠。

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