Department of Orthopedic Surgery, New York University Langone Health, New York, New York, U.S.A.
Department of Orthopedic Surgery, New York University Langone Health, New York, New York, U.S.A..
Arthroscopy. 2024 Mar;40(3):820-827. doi: 10.1016/j.arthro.2023.08.005. Epub 2023 Aug 12.
To compare hip survivorship and patient-reported outcome measures (PROMs) after primary hip arthroscopy at 5-year follow-up between patients with femoroacetabular impingement syndrome (FAIS) with radiographic signs of global acetabular retroversion and those without.
A retrospective matched-cohort study was conducted using a single-surgeon hip arthroscopy database. Patients were included if they underwent primary hip arthroscopy for treatment of FAIS, had preoperative hip x-rays, and had a minimum 5-year follow-up. Global retroversion was defined as the presence of ischial spine sign, posterior wall sign, and crossover sign on anteroposterior view. Patients with FAIS with global retroversion were matched 1:1 on age, sex, and body mass index to FAIS controls. The modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) were administered preoperatively and at follow-up. Hip survivorship and PROMs were compared between the 2 groups using the paired t test, Wilcoxon signed rank test, and/or Cochran-Mantel-Haenszel test as appropriate. P values <.05 were considered significant.
Thirty-eight patients with global retroversion (mean age 40.6 ± 10.8 years, 60.5% female) were matched to 38 controls (mean age 41.3 ± 13.6 years, 60.5% female). Reoperation rates were the same in both groups (5.3%). On average, both groups reported significant pre- to postoperative improvement in mHHS (P < .001) and NAHS (P < .001), and there was no significant intergroup differences in the change in mHHS (P = .86) or NAHS (P = .90). Achievement rates for the patient acceptable symptom state on the mHHS were higher among males compared to females (P = .04) in both the global retroversion group (93.3% vs 73.9%) and the control group (93.3% vs 73.9%).
Patients with FAIS with and without global acetabular retroversion had no significant difference in outcomes after primary hip arthroscopy at a minimum 5-year minimum follow-up.
Level III, retrospective comparative prognostic trial.
比较影像学上存在髋臼整体后倾的髋关节撞击综合征（FAIS）患者与无髋臼整体后倾的 FAIS 患者在初次髋关节镜术后 5 年的髋关节存活率和患者报告的结局测量（PROM）。
这是一项单关节镜医师数据库的回顾性匹配队列研究。纳入标准为：接受初次髋关节镜治疗 FAIS 的患者，术前有髋关节 X 线片，且随访时间至少 5 年。髋臼整体后倾定义为存在坐骨切迹征、后壁征和前-后位上的交叉征。将影像学上存在髋臼整体后倾的 FAIS 患者与 FAIS 对照组按照年龄、性别和体重指数 1:1 进行匹配。在术前和随访时使用改良 Harris 髋关节评分（mHHS）和非关节炎髋关节评分（NAHS）进行评估。使用配对 t 检验、Wilcoxon 符号秩检验和/或 Cochran-Mantel-Haenszel 检验比较两组间的髋关节存活率和 PROM，以适当的方式进行。P 值<.05 为差异有统计学意义。
38 例存在髋臼整体后倾的患者（平均年龄 40.6±10.8 岁，60.5%为女性）与 38 例对照组相匹配（平均年龄 41.3±13.6 岁，60.5%为女性）。两组的再手术率相同（5.3%）。两组患者的 mHHS（P<.001）和 NAHS（P<.001）评分均有显著的术前至术后改善，且 mHHS（P=.86）和 NAHS（P=.90）的变化在两组间无显著差异。在 mHHS 中，男性患者达到可接受的症状状态的比例高于女性（P=.04），无论在存在髋臼整体后倾的组（93.3% vs. 73.9%）还是对照组（93.3% vs. 73.9%）均如此。
在初次髋关节镜术后 5 年的随访中，影像学上存在髋臼整体后倾的 FAIS 患者与无髋臼整体后倾的 FAIS 患者的髋关节镜术后结果无显著差异。
III 级，回顾性比较预后试验。
