Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Sichuan, P. R. China.
West China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital, Sichuan University, Sichuan, P. R. China.
Orthop Surg. 2023 Jun;15(6):1498-1504. doi: 10.1111/os.13707. Epub 2023 Apr 24.
Pigment Villonodular synovitis of the hip, a rare pain proliferation of the synovium, was treated successfully with total hip arthroplasty and arthroscopy. Most recent results come from small case series with no study comparing arthroscopy and arthroplasty. In this study, we aimed to show and compare the clinical outcomes of arthroscopy and total hip arthroplasty (THA) in pigment Villonodular synovitis of the hip.
This was a retrospective clinical trial with data from patients with pigment Villonodular synovitis of the hip between 2010 and 2019. The study included 17 patients in the THA group, and 20 patients in the arthroscopy group. The clinical outcomes were evaluated at 3, 6, and 12 months, at 1 and 2 years, and every 5 years afterward. The clinical efficacy was measured using the Harris hip scores (HHSs) and visual analogue scale (VAS) score.
The mean HHS improved from 45.24 ± 10.36 to 78.94 ± 19.11 in the THA group (t = -6.394, P = 0.000) and 45.30 ± 11.08 to 71.60 ± 19.78 (t = -5.187, P = 0.000) in the arthroscopy group from pre-operation to the final follow-up. There is no significant difference between the two groups (t = 1.051, P = 0.301). The mean VAS improved from 3.65 ± 0.79 to 0.35 ± 0.70 (t = 12.890, P = 0.000) in the THA group and 4.05 ± 0.94 to 1.35 ± 1.79 (t = 5.979, P = 0.001) in the arthroscopy group postoperatively. There is no significant difference between the two groups (t = 1.329, P = 0.193). Recurrence of PVNS was diagnosed in four patients (20%) of the arthroscopy group and they underwent THA after arthroscopy, and the mean interval was 44.25 ± 6.98 months. All patients reached level 5 muscle strength by the final follow-up. All the patients' buckling ranges were over 105 degrees. Their internal and external hip rotation was over 15 degrees. Their hip adduction was over 20 degrees, and abduction over 30 degrees.
Both THA and arthroscopy in the setting of PVNS can improve patients' function and lead to a low rate of local recurrence. By selecting patients well for each approach, one can expect a reasonable result.
髋关节色素绒毛结节性滑膜炎是一种罕见的滑膜增殖性疼痛，通过全髋关节置换术和关节镜治疗可取得成功。最近的结果来自于小病例系列，没有研究比较关节镜和关节置换术。在本研究中，我们旨在展示和比较髋关节色素绒毛结节性滑膜炎的关节镜和全髋关节置换术（THA）的临床结果。
这是一项回顾性临床试验，纳入了 2010 年至 2019 年期间患有髋关节色素绒毛结节性滑膜炎的患者数据。研究包括 THA 组 17 例患者和关节镜组 20 例患者。临床结果在术后 3、6 和 12 个月、1 年和 2 年以及此后每 5 年进行评估。临床疗效采用 Harris 髋关节评分（HHS）和视觉模拟评分（VAS）进行评估。
THA 组的 HHS 从术前的 45.24 ± 10.36 分提高到术后的 78.94 ± 19.11 分（t=-6.394，P=0.000），关节镜组从术前的 45.30 ± 11.08 分提高到术后的 71.60 ± 19.78 分（t=-5.187，P=0.000）。两组之间无显著差异（t=1.051，P=0.301）。VAS 从术前的 3.65 ± 0.79 分降低到术后的 0.35 ± 0.70 分（t=12.890，P=0.000），关节镜组从术前的 4.05 ± 0.94 分降低到术后的 1.35 ± 1.79 分（t=5.979，P=0.001）。两组之间无显著差异（t=1.329，P=0.193）。关节镜组有 4 例（20%）患者诊断为 PVNS 复发，他们在关节镜检查后接受了 THA，平均间隔时间为 44.25 ± 6.98 个月。所有患者在末次随访时均达到 5 级肌力。所有患者的屈曲范围均超过 105 度。内旋和外旋均超过 15 度。髋关节内收超过 20 度，外展超过 30 度。
在 PVNS 中，THA 和关节镜都可以改善患者的功能，并导致局部复发率较低。通过为每种方法选择合适的患者，可以获得合理的结果。
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