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髋关节撞击综合征与骨软骨成形术预防髋关节炎的作用:潘多拉魔盒开启过程。

Femoroacetabular Impingement and the Effect of Osteochondroplasty on Hip Osteoarthritis Prevention: The Pandora's Box Opening Process.

机构信息

Department of Orthopaedic Surgery and Traumatology, Clínica Universidad de Navarra, Pamplona, Spain.

Cell Therapy Area, Clínica Universidad de Navarra, Pamplona, Spain.

出版信息

Cartilage. 2024 Jun;15(2):120-129. doi: 10.1177/19476035231191202. Epub 2023 Sep 18.

Abstract

OBJECTIVE

This study was conducted to assess the effect of osteochondroplasty on osteoarthritis (OA) prevention, comparing radiological evolution between identical hips from the same patient who had undergone unilateral surgery.

DESIGN

We retrospectively reviewed radiological evolution between hips with similar shape from the same patient who had undergone unilateral surgery. In all, 56 FAI patients (112 hips) with a mean age of 42.18 ± 9.16 years and had undergone unilateral arthroscopy treatment have been included. Four independent researchers measured Wiberg, Acetabular and Alpha angles, Extrusion index, and Tönnis classification preoperatively to verify that operated and non-operated hips had the same shape. OA evolution was assessed by joint space width (JSW) in 3 different articular points and Tönnis classification.

RESULTS

No preoperative anatomical differences were present between groups ( > 0.05). At the end of follow-up (31.9 months), a decrease of JSW in the 3 points measured was found in OP hips (OP vs. N-OP; < 0.01). These results were correlated with changes in the proportion of patients who progressed to grade III in Tönnis classification (from 1.3% preoperative to 23.2% at the end of follow-up).

CONCLUSIONS

Osteochondroplasty and labrum procedures were not associated with OA prevention. The OP hips showed a faster OA degeneration, which was not seen in the N-OP. These results will encourage hip surgeons to perform further investigations to avoid the "Pandora's Box Opening Process."

摘要

目的

本研究旨在评估骨软骨成形术对骨关节炎(OA)的预防效果,通过比较同一患者双侧髋关节的影像学进展来评估。

设计

我们回顾性分析了同一患者接受单侧手术的髋关节的影像学进展。共纳入 56 例(112 髋)FAI 患者,平均年龄 42.18 ± 9.16 岁,均接受了单侧髋关节镜治疗。4 位独立研究人员测量术前 Wiberg、髋臼和 Alpha 角、外突指数和 Tönnis 分级,以验证手术侧和非手术侧髋关节具有相同的形态。通过在 3 个不同关节点测量关节间隙宽度(JSW)和 Tönnis 分级评估 OA 进展。

结果

两组患者术前解剖结构无差异( > 0.05)。在随访结束时(31.9 个月),OP 侧髋关节的 3 个测量点的 JSW 均减少(OP 与 N-OP; < 0.01)。这些结果与 Tönnis 分级中进展为 3 级患者的比例变化相关(术前为 1.3%,随访结束时为 23.2%)。

结论

骨软骨成形术和盂唇手术与 OA 预防无关。OP 侧髋关节出现更快的 OA 退变,而 N-OP 侧则没有。这些结果将鼓励髋关节外科医生进行进一步研究,以避免“潘多拉盒子开启过程”。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee17/11368905/e09bdfb1c020/10.1177_19476035231191202-fig1.jpg

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