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髋关节镜治疗股骨髋臼撞击综合征后伴边缘型髋关节发育不良的灵活性运动运动员的结局:至少 2 年随访的倾向性匹配分析。

Outcomes of Flexibility Sport Athletes With Borderline Hip Dysplasia After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Propensity-Matched Analysis at Minimum 2-Year Follow-up.

机构信息

Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA.

出版信息

Am J Sports Med. 2024 May;52(6):1554-1562. doi: 10.1177/03635465241239874. Epub 2024 Apr 8.

Abstract

BACKGROUND

Hip arthroscopy has proved successful in treating femoroacetabular impingement syndrome (FAIS) in patients with and without borderline hip dysplasia (BHD). Despite a high prevalence of BHD in patients who participate in sports with high flexibility requirements, a paucity of literature evaluates the efficacy of hip arthroscopy in treating FAIS in flexibility sport athletes with BHD.

PURPOSE

To compare minimum 2-year patient-reported outcomes (PROs) and achievement of clinically significant outcomes in flexibility sport athletes with BHD undergoing primary hip arthroscopy for FAIS with capsular plication with results in flexibility sport athletes without dysplasia.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

Data were prospectively collected for patients undergoing primary hip arthroscopy for FAIS with BHD, defined as a lateral center-edge angle of 18° to 25°, who reported participation in a sport with a high flexibility requirement, including dance, gymnastics, figure skating, yoga, cheerleading, and martial arts, according to previous literature. These patients were matched 1:2 to flexibility sport athletes without dysplasia, controlling for age, sex, and body mass index. Preoperative and minimum 2-year postoperative PROs were collected and compared between groups. Cohort-specific minimal clinically important difference and patient acceptable symptom state achievement was compared between groups.

RESULTS

In total, 52 flexibility sport athletes with BHD were matched to 104 flexibility sport athletes without BHD. Both groups showed similar sport participation ( = .874) and a similar level of competition ( = .877). Preoperative lateral center-edge angle (22.2°± 1.6° vs 31.5°± 3.9°; < .001) and Tönnis angle (10.9°± 3.7° vs 5.8°± 4.4°; < .001) differed between groups. Capsular plication was performed in all cases. Both groups achieved significant improvement in all PROs ( < .001) with no differences in postoperative PROs between groups (≥ .147). High minimal clinically important difference (BHD group: 95.7%; control group: 94.8%) and patient acceptable symptom state (BHD group: 71.7%; control group: 72.2%) achievement for any PRO was observed with no differences between groups (≥ .835).

CONCLUSION

Flexibility sport athletes with BHD achieved similar outcomes as those of flexibility sport athletes without BHD after hip arthroscopy for FAIS with capsular plication.

摘要

背景

髋关节镜已被证明可成功治疗伴有和不伴有边界性髋关节发育不良(BHD)的股骨髋臼撞击综合征(FAIS)患者。尽管在参加高灵活性要求运动的患者中 BHD 的患病率很高,但文献中很少评估髋关节镜治疗 BHD 灵活性运动运动员 FAIS 的疗效。

目的

比较行髋关节镜下 FAIS 伴盂唇紧缩术治疗 BHD 灵活性运动运动员与无发育不良灵活性运动运动员的至少 2 年患者报告的结局(PRO)和临床显著结局的实现情况。

研究设计

队列研究;证据水平,3 级。

方法

根据既往文献,前瞻性收集行髋关节镜下 FAIS 伴 BHD 患者的资料,BHD 定义为外侧中心边缘角为 18°~25°,患者报告参加了高灵活性要求的运动,包括舞蹈、体操、花样滑冰、瑜伽、啦啦队和武术。这些患者根据年龄、性别和体重指数 1:2 匹配到无发育不良的灵活性运动运动员。比较两组患者的术前和至少 2 年的术后 PRO。比较两组的队列特异性最小临床重要差异和患者可接受的症状状态的实现情况。

结果

共纳入 52 例 BHD 灵活性运动运动员,匹配 104 例无 BHD 的灵活性运动运动员。两组的运动参与情况相似(=0.874),比赛水平也相似(=0.877)。术前外侧中心边缘角(22.2°±1.6°比 31.5°±3.9°;<0.001)和 Tönnis 角(10.9°±3.7°比 5.8°±4.4°;<0.001)存在差异。所有病例均行盂唇紧缩术。两组患者的所有 PRO 均有显著改善(<0.001),但组间术后 PRO 无差异(≥0.147)。高最小临床重要差异(BHD 组:95.7%;对照组:94.8%)和患者可接受症状状态(BHD 组:71.7%;对照组:72.2%)的实现情况在两组之间无差异(≥0.835)。

结论

髋关节镜下 FAIS 伴盂唇紧缩术治疗 BHD 灵活性运动运动员与无 BHD 灵活性运动运动员的结局相似。

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