Sports Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Institute of Rehabilitation, Sichuan University, West China Hospital, Chengdu, China.
Orthop Surg. 2023 Nov;15(11):2848-2854. doi: 10.1111/os.13855. Epub 2023 Sep 7.
Pelvic compensation is common in femoroacetabular impingement (FAI) patients to reduce symptoms and increase range of motion. However, little attention was given to the postoperative clinical effect of pelvic compensation. Therefore, this study aims to compare the outcomes between pelvic compensation and normal pelvic position in femoroacetabular impingement (FAI) patients after hip arthroscopy.
The retrospective study was conducted from January 2019 to June 2022, recruited consecutive patients who were diagnosed with FAI and received subsequent arthroscopic treatment. All patients completed an X-ray in the anterior-posterior standing position before and 4 weeks after surgery. Patients with pelvic compensation were compared with those who did not. Functional outcomes included hip disability and osteoarthritis outcome score (HOOS), modified Harris (mHHS) score, and lower-extremity activity scale (LEAS). Secondary outcomes included the EuroQol Five Dimensions Questionnaire (EQ-5D) and patient satisfaction. The intraclass correlation coefficient (ICC) was used to analyze interobserver and intraobserver reliability.
Ninety patients with a mean age of 39.40 years were included in the study. No significant compensation changes were noted within groups after the elimination of impingement. The functional scores showed no significant difference between groups (p(HOOS) = 0.352, p(mHHS) = 0.183, p(LEAS) = 0.865). The EQ-5D revealed statistically better performance in usual activities in the compensatory group (p = 0.044). There are no significant between-group differences in patients' satisfaction evaluations.
As assessed by Patient-Reported Outcome Measures (PROMs), patients with compensatory pelvic tilt demonstrated similar clinical outcomes without extra adverse events to patients with normal pelvic positioning in short-term follow-ups. Furthermore, compensatory pelvic tilt did not significantly enhance the range of motion or functional outcome at short-term follow-ups.
骨盆补偿在股骨髋臼撞击症（FAI）患者中很常见，可减轻症状并增加活动范围。然而，对于骨盆补偿术后的临床效果关注甚少。因此，本研究旨在比较髋关节镜术后骨盆补偿与正常骨盆位置对股骨髋臼撞击症（FAI）患者的疗效。
本回顾性研究于 2019 年 1 月至 2022 年 6 月进行，招募了连续诊断为 FAI 并接受后续关节镜治疗的患者。所有患者均在术前和术后 4 周拍摄前后位站立位 X 线片。将存在骨盆补偿的患者与不存在骨盆补偿的患者进行比较。功能结果包括髋关节残疾和骨关节炎结果评分（HOOS）、改良 Harris（mHHS）评分和下肢活动量表（LEAS）。次要结果包括欧洲五维健康量表（EQ-5D）和患者满意度。采用组内相关系数（ICC）分析观察者内和观察者间的可靠性。
本研究共纳入 90 例平均年龄为 39.40 岁的患者。在消除撞击后，组内未见明显的补偿性变化。组间功能评分无显著差异（p(HOOS)=0.352，p(mHHS)=0.183，p(LEAS)=0.865）。EQ-5D 显示在日常活动方面补偿组的表现明显更好（p=0.044）。患者满意度评估无显著组间差异。
通过患者报告的结果测量（PROMs）评估，在短期随访中，具有补偿性骨盆倾斜的患者与具有正常骨盆位置的患者相比，临床结果相似，无额外不良事件。此外，在短期随访中，补偿性骨盆倾斜并未显著增加活动范围或功能结果。
