Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A.; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A.; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.; Department of Orthopaedic Surgery, Faculty of Medicine, Acibadem University, Istanbul, Turkey.
Arthroscopy. 2024 Nov;40(11):2695-2703.e1. doi: 10.1016/j.arthro.2024.02.016. Epub 2024 Feb 22.
To perform a multinational survey and identify patterns in capsular management at the time of hip arthroscopy.
An anonymous, nonvalidated survey was distributed by the American Orthopaedic Society for Sports Medicine; Arthroscopy Association of North America; European Society of Sports Traumatology, Knee Surgery & Arthroscopy; International Society for Hip Arthroscopy; and Turkish Society of Sports Traumatology, Arthroscopy, and Knee Surgery. The questions were broken down into 6 categories: demographic characteristics, capsulotomy preference, traction stitches, capsular closure, postoperative rehabilitation, and postoperative complications.
The survey was completed by 157 surgeons. Surgeons who performed half or full T-type capsulotomies had 2.4 higher odds of using traction sutures for managing both the peripheral and central compartments during hip arthroscopy for femoroacetabular impingement (P = .024). Surgeons who believed that there was sufficient literature regarding the importance of hip capsular closure had 1.9 higher odds of routinely performing complete closure of the capsule (P = .044). Additionally, surgeons who practiced in the United States had 8.1 higher odds of routinely closing the capsule relative to international surgeons (P < .001). Moreover, surgeons who received hip arthroscopy training in residency or fellowship had 2.4 higher odds of closing the capsule completely compared with surgeons who did not have exposure to hip arthroscopy during their training (P = .009).
Geographic and surgeon-related variables correlate with capsular management preferences during hip arthroscopy. Surgeons who perform half or full T-capsulotomies more often use traction stitches for managing both the peripheral and central compartments. Surgeons performing routine capsular closure are more likely to believe that sufficient evidence is available to support the practice, with surgeons in the United States being more likely to perform routine capsular closure in comparison to their international colleagues.
As the field of hip preservation continues to evolve, capsular management will likely continue to play an important role in access, instrumentation, and postoperative outcomes.
进行一项多国家调查，确定髋关节镜检查时囊管理的模式。
美国矫形运动医学学会；北美关节镜协会；欧洲运动创伤学、膝关节外科和关节镜学会；国际髋关节镜学会；以及土耳其运动创伤学、关节镜和膝关节外科学会通过匿名、未经验证的调查进行。问题分为 6 类：人口统计学特征、囊切开偏好、牵引缝线、囊闭合、术后康复和术后并发症。
共有 157 名外科医生完成了调查。进行半 T 型或全 T 型囊切开术的外科医生在髋关节镜治疗股骨髋臼撞击症时，使用牵引缝线管理外周和中央间隙的可能性高 2.4 倍（P=0.024）。认为有关髋关节囊闭合重要性的文献足够的外科医生，常规完全闭合囊的可能性高 1.9 倍（P=0.044）。此外，与国际外科医生相比，在美国执业的外科医生常规闭合囊的可能性高 8.1 倍（P<0.001）。此外，在住院医师或研究员阶段接受髋关节镜培训的外科医生，与未接受髋关节镜培训的外科医生相比，完全闭合囊的可能性高 2.4 倍（P=0.009）。
地理和外科医生相关变量与髋关节镜检查时的囊管理偏好相关。进行半 T 型或全 T 型囊切开术的外科医生更常使用牵引缝线来管理外周和中央间隙。常规进行囊闭合的外科医生更有可能认为有足够的证据支持这种做法，与国际同行相比，美国的外科医生更有可能常规进行囊闭合。
随着髋关节保护领域的不断发展，囊管理在入路、器械和术后结果方面可能继续发挥重要作用。
