接受髋关节镜下翻修术伴盂唇重建或增强的患者报告结局良好：系统评价。
Patients Undergoing Revision Hip Arthroscopy With Labral Reconstruction or Augmentation Demonstrate Favorable Patient Reported Outcomes: A Systematic Review.
机构信息
Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A.
Case Western Reserve University School of Medicine, Cleveland, Ohio, U.S.A.
出版信息
Arthroscopy. 2024 Jun;40(6):1923-1937. doi: 10.1016/j.arthro.2023.11.027. Epub 2023 Dec 27.
PURPOSE
To review current literature evaluating patient-reported outcomes (PROs) and survivorship in patients undergoing revision hip arthroscopy with labral reconstruction or augmentation.
METHODS
A systematic review was performed with the following key words: (revision) AND (hip OR femoroacetabular impingement) AND (arthroscopy OR arthroscopic) AND (reconstruction OR augmentation OR irreparable). PubMed, Cochrane Trials, and Scopus were queried in October 2022 using the criteria established in the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Studies were included if they involved patients undergoing revision hip arthroscopy with labral reconstruction or augmentation and reported preoperative and postoperative PROs at minimum 2-year follow-up. Only original research articles were included. Survivorship was defined as a nonconversion to total hip arthroplasty. Outcomes present in 3 or more studies underwent further statistical analysis with forest plots. Heterogeneity of studies was evaluated using the I statistic.
RESULTS
Five studies were reviewed, including 359 revision hip arthroscopies (335 with complete follow-up) with a follow-up that ranged from 2.2 to 5.2 years. Four studies reported on outcomes after revision labral reconstruction and 1 study reported on labral augmentation. Two out of 5 included studies evaluated for statistical significance between preoperative and postoperative outcomes. Three out of 5 studies reported a rate of at least 70% for achieving minimal clinically important difference in at least 1 PRO. At minimum 2-year follow-up, survivorship ranged from 93.5% to 100%.
CONCLUSIONS
Patients that underwent revision hip arthroscopy with labral reconstruction or augmentation demonstrated improvement in PROs with mixed rates of achieving clinical benefit and rates of survivorship at minimum 2-year follow-up ranging from 93.5% to 100%.
LEVEL OF EVIDENCE
Level IV, systematic review of level III to IV studies.
目的
回顾目前评估接受髋关节镜下盂唇重建或增强修复术的翻修患者的患者报告结局（PROs）和生存情况的文献。
方法
通过以下关键词进行系统回顾：（翻修）和（髋关节或股骨髋臼撞击症）和（关节镜或关节镜检查）和（重建或增强或不可修复）。2022 年 10 月，使用系统评价和荟萃分析的首选报告项目中规定的标准，在 PubMed、Cochrane 试验和 Scopus 中进行了查询。如果研究涉及接受髋关节镜下盂唇重建或增强修复术的翻修患者，并在至少 2 年的随访中报告了术前和术后 PROs，则纳入研究。仅纳入原始研究文章。生存定义为未转为全髋关节置换术。有 3 项或更多研究报告的结果进行了进一步的统计分析，使用森林图。使用 I 统计评估研究的异质性。
结果
共审查了 5 项研究，包括 359 例髋关节镜下翻修手术（335 例有完整随访），随访时间为 2.2 至 5.2 年。4 项研究报告了髋关节镜下盂唇重建后的结果，1 项研究报告了盂唇增强的结果。5 项研究中有 2 项评估了术前和术后结局之间的统计学意义。5 项研究中有 3 项报告至少有 1 项 PRO 达到最小临床重要差异的比例至少为 70%。在至少 2 年的随访中，生存率为 93.5%至 100%。
结论
接受髋关节镜下盂唇重建或增强修复术的翻修患者的 PROs 得到改善，混合了实现临床获益的比例和至少 2 年随访的生存率，从 93.5%到 100%不等。
证据等级
IV 级，III 级至 IV 级研究的系统评价。
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