Hapa Onur, Aydemir Selahaddin, Akdogan Asli Irmak, Celtik Mustafa, Aydin Ozgur, Gocer Batuhan, Gursan Onur
Department of Orthopedics, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
Department of Radiology, Katip Celebi University Faculty of Medicine, Izmir, Turkey.
Arthrosc Sports Med Rehabil. 2024 Apr 9;6(3):100943. doi: 10.1016/j.asmr.2024.100943. eCollection 2024 Jun.
To evaluate whether unrepaired interportal capsulotomy presents with capsular defect on magnetic resonance imaging (MRI) 5 years after primary hip arthroscopy and to determine its effect on functional results and findings of osteoarthritis on radiographs or MRI scans.
Patients with femoroacetabular impingement (without arthritis or dysplasia) were retrospectively reviewed after arthroscopic labral repair or debridement and femoroplasty through interportal capsulotomy without closure. Patients were assessed preoperatively and at a minimum of 5 years postoperatively using patient-reported outcomes (Hip Outcome Score-Activities of Daily Living scale, modified Harris Hip Score, and visual analog scale pain score), radiographic measures, and MRI scans.
Forty patients (42 hips) were deemed eligible for the study and were evaluated. Of the hips, 81% had healed capsules, whereas 8 (19%) had capsular defects on the latest MRI scan. There were 3 hips with subchondral edema in the defect group compared with 1 in the healed-capsule group ( = .01) on the latest MRI scan, which was not present on preoperative MRI (still positive on multivariate analysis when the preoperative alpha angle was also taken into consideration). Functional results did not differ between the groups ( > .05).
In this study, 81% of interportal capsulotomies healed without repair at 5 years after primary hip arthroscopy.
Understanding the prevalence and implications of unhealed capsulotomies could encourage surgeons to be meticulous in capsular closure.
评估初次髋关节镜检查5年后，未修复的经门间关节囊切开术在磁共振成像（MRI）上是否存在关节囊缺损，并确定其对功能结果以及X线片或MRI扫描上骨关节炎表现的影响。
对经关节镜盂唇修复或清创以及通过经门间关节囊切开术（未缝合）进行股骨成形术的股骨髋臼撞击症患者（无关节炎或发育异常）进行回顾性研究。术前以及术后至少5年对患者进行评估，评估指标包括患者报告的结果（髋关节结果评分-日常生活活动量表、改良Harris髋关节评分和视觉模拟量表疼痛评分）、影像学测量以及MRI扫描。
40例患者（42髋）被认为符合研究条件并接受评估。其中，81%的髋关节关节囊已愈合，而在最新的MRI扫描中，8例（19%）存在关节囊缺损。在最新的MRI扫描中，缺损组有3髋出现软骨下水肿，而愈合关节囊组有1髋出现（P = 0.01），术前MRI未出现这种情况（在多变量分析中，当同时考虑术前α角时仍为阳性）。两组之间的功能结果无差异（P>0.05）。
在本研究中，初次髋关节镜检查5年后，81%的经门间关节囊切开术未修复也已愈合。
了解未愈合关节囊切开术的发生率及影响，可能会促使外科医生在关节囊缝合时更加细致。
