Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
University of Connecticut School of Medicine, Farmington, Connecticut, U.S.A.
Arthroscopy. 2023 Dec;39(12):2547-2567. doi: 10.1016/j.arthro.2023.05.004. Epub 2023 May 18.
To review outcomes of patients with low-back pathology undergoing primary hip arthroscopy for the treatment of femoroacetabular impingement (FAI) syndrome.
The PubMed, Cochrane Trials, and Scopus databases were queried in June 2022 to conduct this systematic review using the following terms: ("hip" OR "femoroacetabular impingement") AND ("arthroscopy" OR "arthroscopic") AND ("spine" OR "lumbar" OR "sacral" OR "hip-spine" OR "back") AND ("outcomes"). Articles were included if they reported on patient-reported outcomes (PROs) and/or clinical benefit of patients undergoing hip arthroscopy with concomitant low-back pathology. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Case reports, opinion articles, review articles, and technique articles were excluded from this study. Forest plots were created to analyze preoperative and postoperative outcomes among patients with low-back pathology.
Fourteen studies were included in the review. There were 750 hips with low-back pathology and FAI (hip-spine syndrome) and 1,800 hips with only FAI (no hip-spine syndrome). All 14 studies reported PROs. In 4 studies in the group with hip-spine syndrome and 8 studies in the group with FAI without low-back pathology, the respective cohorts were reported to achieve the minimal clinically important difference in at least 1 PRO at a rate of 80%. Eight studies reported that patients with low-back pathology were associated with inferior outcomes or clinical benefit compared with patients without low-back pathology.
Patients undergoing primary hip arthroscopy with concomitant low-back pathology can expect favorable outcomes, but outcomes are superior in patients undergoing hip arthroscopy for FAI alone compared with FAI with concomitant low-back pathology.
Level IV, systematic review of Level II to Level IV studies.
回顾因髋关节撞击综合征（FAI）而行初次髋关节镜治疗的腰椎病变患者的治疗结果。
2022 年 6 月，通过检索 PubMed、Cochrane 临床试验数据库和 Scopus 数据库，使用以下术语进行了这项系统评价：（“髋关节”或“髋关节撞击综合征”）和（“关节镜检查”或“关节镜检查术”）和（“脊柱”或“腰椎”或“骶骨”或“髋关节-脊柱”或“背部”）和（“结果”）。如果文章报告了接受髋关节镜检查合并腰椎病变的患者的患者报告结局（PRO）和/或临床获益，则将其纳入。本研究排除了病例报告、观点文章、综述文章和技术文章。创建森林图来分析有腰椎病变的患者的术前和术后结果。
该综述纳入了 14 项研究。共有 750 髋存在腰椎病变和 FAI（髋关节-脊柱综合征），1800 髋仅存在 FAI（无髋关节-脊柱综合征）。所有 14 项研究均报告了 PRO。在髋关节-脊柱综合征组的 4 项研究和无腰椎病变的 FAI 组的 8 项研究中，分别有 80%的患者在至少 1 项 PRO 中达到了最小临床重要差异。有 8 项研究报告称，与无腰椎病变的患者相比，有腰椎病变的患者的结局或临床获益较差。
接受初次髋关节镜治疗合并腰椎病变的患者可以获得良好的结果，但与单纯髋关节镜治疗 FAI 的患者相比，髋关节镜治疗 FAI 合并腰椎病变的患者的结果较差。
IV 级，对 II 级至 IV 级研究的系统评价。
