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 Apr;40(4):1177-1185. doi: 10.1016/j.arthro.2023.09.003. Epub 2023 Sep 14.
To compare hip survivorship and patient-reported outcomes after primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients with versus without comorbid borderline hip dysplasia (BHD) at 2-year follow-up.
A retrospective matched-cohort study was conducted involving patients who underwent primary hip arthroscopy for FAIS with a single surgeon from 2010 to 2019. BHD was defined as lateral center edge angle (LCEA) of 20 to 25°. Subjects with BHD were matched 1:2 to controls without BHD on age, sex, body mass index, and preoperative modified Harris Hip Score (mHHS). Alpha angle, LCEA, Tönnis angle, and acetabular retroversion signs were measured on preoperative and/or postoperative hip radiographs. Patient-reported outcomes were assessed using the mHHS and the Non-Arthritic Hip Score. Hip survivorship, outcome scores, and achievement of the minimum clinically important difference were compared between groups using the Mann-Whitney U test or Fisher exact test, as appropriate. P values <.05 were considered significant.
Thirty-one BHD subjects (mean age 36.8 years, 71.0% female) and 62 controls (mean age 38.0 years, 71.0% female) were included. There were no significant intergroup differences in demographics or preoperative radiographic measurements besides LCEA and Tönnis angle (all P > .05). Intraoperatively, subjects with BHD were found to have significantly shorter labral tears (mean 2.6 vs 2.8 clock-face hours, P = .048), but there were no significant intergroup differences in acetabular or femoral cartilage status (all P > .05). Postoperatively, there were no significant intergroup differences in rates of revision arthroscopy (BHD 6.5% vs control 11.3%) or conversion to total hip arthroplasty (BHD 9.7% vs control 1.6%), in 2-year improvement of the mHHS and Non-Arthritic Hip Score, or in minimum clinically important difference achievement rates (all P > .05).
BHD is not associated with a significant difference in hip survivorship or patient-reported outcomes following primary hip arthroscopy for FAIS.
Level III, retrospective comparative study.
比较髋关节撞击综合征（FAIS）患者中存在合并症的边缘性髋关节发育不良（BHD）与不存在合并症的患者在初次髋关节镜术后 2 年的髋关节存活率和患者报告的结果。
这是一项回顾性匹配队列研究，纳入了 2010 年至 2019 年期间由同一位外科医生行初次髋关节镜治疗 FAIS 的患者。BHD 的定义为外侧中心边缘角（LCEA）为 20 至 25°。在年龄、性别、体重指数和术前改良 Harris 髋关节评分（mHHS）方面，将存在 BHD 的患者与不存在 BHD 的对照组进行 1:2 配对。在术前和/或术后髋关节 X 线片上测量 α 角、LCEA、Tönnis 角和髋臼后倾征象。使用 mHHS 和非关节炎髋关节评分评估患者报告的结果。使用 Mann-Whitney U 检验或 Fisher 确切检验比较两组之间的髋关节存活率、结果评分和达到最小临床重要差异的情况，适当情况下使用 P 值<.05 表示差异有统计学意义。
31 名 BHD 患者（平均年龄 36.8 岁，71.0%为女性）和 62 名对照组患者（平均年龄 38.0 岁，71.0%为女性）被纳入研究。除 LCEA 和 Tönnis 角（均 P >.05）外，两组间在人口统计学资料或术前放射学测量值方面均无显著差异。术中发现 BHD 患者的盂唇撕裂明显更短（平均 2.6 个时钟面小时 vs 2.8 个时钟面小时，P =.048），但髋臼和股骨软骨状态无显著差异（均 P >.05）。术后，BHD 组和对照组的翻修关节镜检查率（BHD 组 6.5% vs 对照组 11.3%）或转为全髋关节置换术的比率（BHD 组 9.7% vs 对照组 1.6%）、mHHS 和非关节炎髋关节评分的 2 年改善率以及达到最小临床重要差异的比率（均 P >.05）均无显著差异。
在初次髋关节镜治疗 FAIS 后，BHD 与髋关节存活率或患者报告的结果无显著相关性。
III 级，回顾性比较研究。
