髋关节撞击综合征——风湿科医生需要了解的内容。
Femoroacetabular impingement - What the rheumatologist needs to know.
机构信息
Nepean Hospital, Kingswood, NSW, 2747, Australia; Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2065, Australia.
Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2065, Australia; University of Newcastle and Department of Orthopaedic Surgery, John Hunter Hospital, New Lambton, NSW, 2305, Australia.
出版信息
Best Pract Res Clin Rheumatol. 2024 Mar;38(1):101932. doi: 10.1016/j.berh.2024.101932. Epub 2024 Feb 9.
Femoroacetabular impingement (FAI) syndrome is a common cause of hip and groin pain in young individuals. FAI syndrome is a triad of signs, symptoms, and imaging findings. Necessary but not sufficient for the diagnosis of FAI syndrome is the presence of cam and/or pincer morphology of the hip. However, pathological thresholds for cam and pincer morphologies are not well-established. Management of FAI syndrome is typically through either physiotherapist-led therapy or surgical intervention. Physiotherapist-led management involves exercises aimed to optimise movement patterns of the hip and pelvis to prevent impingement from occurring, activity modification and analgesia, whereas surgical management involves arthroscopic resection of the cam/pincer morphology and treatment of concomitant soft tissue pathologies such as labral tears, cartilage lesions or ligamentum teres tears. Careful consideration of intervention is required given that FAI syndrome may predispose those affected to developing future osteoarthritis of the hip. In most clinical trials, hip arthroscopy has been found to provide greater improvement in patient-reported outcomes in the short-term compared to physiotherapy, however it is unknown whether this is sustained in the long-term or affects the future development of hip osteoarthritis.
髋关节撞击综合征(FAI)是年轻人群髋关节和腹股沟疼痛的常见原因。FAI 综合征是一种三联征,包括体征、症状和影像学发现。髋关节凸轮和/或钳夹畸形的存在对于 FAI 综合征的诊断是必要的,但不是充分的。FAI 综合征的治疗通常包括理疗师主导的治疗或手术干预。理疗师主导的管理包括旨在优化髋关节和骨盆运动模式以防止撞击发生的运动,活动修改和镇痛,而手术管理包括凸轮/钳夹形态的关节镜切除以及治疗伴随的软组织病变,如盂唇撕裂、软骨损伤或圆韧带撕裂。需要仔细考虑干预措施,因为 FAI 综合征可能使受影响的人易发生未来的髋关节骨关节炎。在大多数临床试验中,与物理治疗相比,髋关节镜检查在短期内提供了更好的患者报告结果改善,然而,尚不清楚这种改善是否在长期持续,或者是否会影响未来髋关节骨关节炎的发展。