American Hip Institute Research Foundation, Chicago, Illinois.
American Hip Institute, Chicago, Illinois.
J Bone Joint Surg Am. 2024 Jun 19;106(12):1062-1068. doi: 10.2106/JBJS.23.00648. Epub 2024 Apr 25.
Hip arthroscopy has demonstrated effectiveness as a treatment for femoroacetabular impingement (FAI) in adult patients, with promising long-term outcomes. However, there is a paucity of literature regarding the adolescent population. The purposes of our study were to report on survivorship and patient-reported outcomes (PROs) at a minimum 10-year follow-up in adolescent patients who underwent hip arthroscopy for FAI and labral tears and to compare the survivorship and outcomes of this population with those of a nested, propensity-matched adult control group.
Data regarding adolescent patients who underwent primary hip arthroscopy between February 2008 and January 2012 were reviewed. Patients with a minimum 10-year follow-up for the modified Harris hip score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), and visual analog scale (VAS) for pain were eligible. The exclusion criteria were previous ipsilateral hip conditions or surgical procedures, a Tönnis grade of >1, or dysplasia. In the subanalysis, adolescent patients were matched to young adult patients with use of a 1:1 ratio on the basis of sex, body mass index, Tönnis grade, lateral center-edge angle (LCEA), labral treatment, capsular treatment, and additional procedures performed during the surgery.
A total of 74 patients (61 female and 13 male; 74 hips) with a mean (and standard deviation) age of 16.7 ± 1.4 years and a minimum follow-up of 10 years were included. The latest follow-up occurred at a mean of 125.4 ± 5.3 months (range, 120.0 to 144.1 months). Significant improvement in all PROs from baseline and 100% survivorship were demonstrated at the 10-year follow-up. In the subanalysis, 58 adolescent hips were propensity-matched to 58 young adult hips. The adolescent group had higher postoperative scores for the HOS-SSS (p = 0.021), NAHS (p = 0.021), and iHOT-12 (p = 0.042) than the young adult group. Patient satisfaction at the latest follow-up was also significantly higher in the adolescent group (p = 0.00061). The rate of survivorship free from conversion to THA was similar between the adolescent and control groups (100% versus 96.6%; p = 0.200).
Adolescents undergoing hip arthroscopy for the treatment of FAI and labral tears demonstrated excellent outcomes and a high rate of survivorship. These outcomes were superior to those seen in a matched adult group. The results of this study indicate that hip arthroscopy in adolescents is a safe procedure that leads to improvement in outcomes at long-term follow-up.
Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
髋关节镜已被证明是治疗成人股骨髋臼撞击症（FAI）的有效方法，具有良好的长期疗效。然而，关于青少年人群的文献却很少。本研究的目的是报告青少年患者接受髋关节镜治疗 FAI 和盂唇撕裂的 10 年以上的生存率和患者报告的结果（PROs），并比较该人群与嵌套的、倾向匹配的成年对照组的生存率和结果。
回顾了 2008 年 2 月至 2012 年 1 月期间接受初次髋关节镜治疗的青少年患者的数据。符合改良 Harris 髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）、髋关节结果评分运动特异性亚量表（HOS-SSS）、国际髋关节结果工具-12（iHOT-12）和疼痛视觉模拟评分（VAS）至少 10 年随访的患者有资格入组。排除标准包括同侧髋关节疾病或手术史、Tönnis 分级>1 或发育不良。在亚分析中，青少年患者根据性别、体重指数、Tönnis 分级、外侧中心边缘角（LCEA）、盂唇处理、囊处理以及手术中进行的其他手术，与年轻成年患者进行 1:1 比例的匹配。
共纳入 74 例患者（61 例女性，13 例男性；74 髋），平均（标准差）年龄为 16.7±1.4 岁，随访时间至少 10 年。末次随访平均时间为 125.4±5.3 个月（范围为 120.0 至 144.1 个月）。在 10 年随访时，所有 PRO 均显著改善，且生存率为 100%。在亚分析中，58 例青少年髋关节与 58 例年轻成年髋关节进行了倾向匹配。与年轻成年组相比，青少年组的 HOS-SSS（p=0.021）、NAHS（p=0.021）和 iHOT-12（p=0.042）术后评分更高。在末次随访时，青少年组的患者满意度也显著更高（p=0.00061）。青少年组和对照组之间免于转为全髋关节置换术（THA）的生存率无显著差异（100%与 96.6%；p=0.200）。
青少年接受髋关节镜治疗 FAI 和盂唇撕裂的疗效优异，生存率高。这些结果优于匹配的成年组。本研究结果表明，青少年髋关节镜手术是一种安全的手术，可在长期随访中改善预后。
治疗性 IV 级。请参阅作者说明以获取完整的证据等级描述。
