Orthopedic Department, Hospital Arnau de Vilanova, Valencia, Spain.
Orthopedic Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
J ISAKOS. 2024 Aug;9(4):587-591. doi: 10.1016/j.jisako.2024.04.017. Epub 2024 May 3.
This study aimed to investigate if there is a relationship between cam femoroacetabular impingement syndrome (cam-FAIS) and chronic anterior knee pain (AKP).
This is a pilot retrospective review of 12 AKP patients with no structural anomalies in the patellofemoral joint and no skeletal malalignment in the lower limbs. All the patients were resistant to proper conservative treatment for AKP (AKP-R). Subsequently, these patients developed pain in the ipsilateral hip several months later, and upon evaluation, were diagnosed with cam-FAIS. Arthroscopic femoral osteoplasty and labral repair were performed and clinical follow-up of hip and knee pain and function (Kujala Score and Non-arthritic Hip Score -NAHS-) was carried out.
All the patients showed improvement in the knee and hip pain scores with a statistically significant clinical difference in all of them at 69 months follow up (range: 18 to 115) except one patient without improvement in the groin VAS score post-operatively. Visual analogical scale (VAS) of knee pain improved from 6.3 (range: 5 to 8) to a postoperative 0.5 (range: 0 to 3.5), (p < 0.001). The VAS of groin pain improved from 4.4 (range: 2 to 8) to a postoperative 0.9 (range: 0 to 3), (p < 0.001). NAHS improved from a preoperative 67.9 (range: 28.7 to 100) to a postoperative 88 (range: 70 to 100), (p < 0.015) and knee Kujala's score improved from a preoperative 48.7 (range: 22 to 71) to a postoperative 96 (range: 91 to 100), (p < 0.001).
This study's principal finding suggests an association between cam-FAIS and AKP-R in young patients who exhibit normal knee imaging and lower limbs skeletal alignment. Addressing cam-FAIS in these cases leads to resolution of both groin and knee pain, resulting in improved functional outcomes for both joints.
Retrospective cohort series with a single contemporaneous long-term follow-up.
IV.
本研究旨在探讨股骨髋臼撞击综合征(cam-FAIS)与慢性前膝痛(AKP)之间是否存在关联。
这是一项对 12 例 AKP 患者的前瞻性回顾性研究,这些患者的髌股关节无结构异常,下肢无骨骼畸形。所有患者对 AKP 的适当保守治疗均有抵抗(AKP-R)。随后,这些患者在数月后出现同侧髋关节疼痛,并在评估后被诊断为 cam-FAIS。对这些患者行髋关节镜下股骨成形术和盂唇修复术,并对其髋膝疼痛和功能(Kujala 评分和非关节炎髋关节评分-NAHS-)进行临床随访。
所有患者的膝髋疼痛评分均有改善,在 69 个月的随访中(范围:18 至 115),除 1 例患者术后腹股沟 VAS 评分无改善外,所有患者均有统计学差异(p<0.001)。膝关节疼痛的视觉模拟评分(VAS)从 6.3(范围:5 至 8)改善到术后 0.5(范围:0 至 3.5)(p<0.001)。腹股沟疼痛的 VAS 从 4.4(范围:2 至 8)改善到术后 0.9(范围:0 至 3)(p<0.001)。NAHS 从术前的 67.9(范围:28.7 至 100)改善到术后的 88(范围:70 至 100)(p<0.015),膝关节 Kujala 评分从术前的 48.7(范围:22 至 71)改善到术后的 96(范围:91 至 100)(p<0.001)。
本研究的主要发现表明,在表现出正常膝关节影像学和下肢骨骼排列的年轻患者中,cam-FAIS 与 AKP-R 之间存在关联。在这些病例中解决 cam-FAIS 问题可导致腹股沟和膝关节疼痛的缓解,从而改善两个关节的功能结果。
回顾性队列研究,具有单一的同期长期随访。
IV 级。