Melugin Heath P, Comfort Spencer M, Shelton Trevor S, Day Hannah K, Ruzbarsky Joseph J, Dornan Grant J, Philippon Marc J
Center for Outcomes-Based Orthopaedic Research, Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA.
Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport, 181 W Meadow Dr, Ste 400, Vail, CO 81657, USA.
J Hip Preserv Surg. 2023 Sep 9;10(3-4):197-203. doi: 10.1093/jhps/hnad026. eCollection 2023 Aug-Dec.
To evaluate the patient-reported outcomes (PROs) and survivorship of combined arthroscopic hip labral reconstruction/augmentation, capsular reconstruction, femoral neck remplissage and lysis of adhesions. Patients ≥18 years old who underwent this combination of procedures during revision hip arthroscopy and were eligible for minimum 2-year follow-up were identified. PRO scores including Hip Outcome Score (HOS)-Activities of Daily Living scale, HOS-Sports scale, modified Harris Hip Score, Short Form 12, and Western Ontario & McMaster Universities Osteoarthritis Index, patient satisfaction and failure rates were analyzed. Seven patients (5 females and 2 males) with average age of 45.0 ± 5.2 (range: 40-54 years) met inclusion criteria. Patients had a median of 1 (range: 1-3) prior hip surgery at an outside institution. All patients had previously undergone femoral osteoplasty, and 85% (6/7) of patients had a labral repair performed. Four patients had no capsule closure performed in their prior procedures. Six patients were available for minimum 2-year follow-up. Two patients converted to total hip arthroplasty: one patient with four prior hip arthroscopies and the other had advanced osteoarthritis with outerbridge grade 3/4 defects requiring microfracture. Mean patient satisfaction was 7 (range: 2-9). At mean follow-up of 3 years, most patients who underwent the combination of labral reconstruction, capsular reconstruction, femoral neck remplissage and lysis of adhesions during revision hip arthroscopy demonstrated improved PROs. This salvage procedure has the potential to restore hip function in patients who have failed an initial hip arthroscopy procedure. In patients with these pathologies present and concomitant joint space narrowing, a total hip arthroplasty may be a more appropriate salvage option.
评估患者报告的关节镜下髋关节盂唇重建/增强、关节囊重建、股骨颈填充及粘连松解联合手术的疗效及生存率。纳入年龄≥18岁、在髋关节翻修关节镜手术期间接受了上述联合手术且符合至少2年随访条件的患者。分析患者报告结局（PRO）评分，包括髋关节功能评分（HOS）-日常生活量表、HOS-运动量表、改良Harris髋关节评分、简明健康状况调查量表12项、西安大略和麦克马斯特大学骨关节炎指数、患者满意度及失败率。7例患者（5例女性，2例男性）符合纳入标准，平均年龄45.0±5.2岁（范围：40-54岁）。患者在外院接受髋关节手术的中位次数为1次（范围：1-3次）。所有患者此前均接受过股骨截骨术，85%（6/7）的患者曾行盂唇修复术。4例患者在前次手术中未进行关节囊闭合。6例患者可进行至少2年的随访。2例患者转为全髋关节置换术：1例患者此前接受过4次髋关节镜手术，另1例患有晚期骨关节炎，外桥分级为3/4级缺损，需要进行微骨折治疗。患者平均满意度为7分（范围：2-9分）。平均随访3年时，大多数在髋关节翻修关节镜手术期间接受盂唇重建、关节囊重建、股骨颈填充及粘连松解联合手术的患者PRO得到改善。这种挽救手术有可能恢复初次髋关节镜手术失败患者的髋关节功能。对于存在这些病变且伴有关节间隙变窄的患者，全髋关节置换术可能是更合适的挽救选择。
