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关节镜治疗髋关节撞击综合征:最新综述。

Arthroscopic Treatment of Femoroacetabular Impingement Syndrome: An Updated Review.

机构信息

Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Clin Orthop Surg. 2024 Aug;16(4):517-525. doi: 10.4055/cios23307. Epub 2024 Jun 26.

Abstract

Treatment strategies for femoroacetabular impingement (FAI) syndrome have evolved in tandem with increased comprehension of FAI's impact on hip joint health. Early intervention, including arthroscopic surgery, has gained popularity due to its potential to delay the progression of osteoarthritis. Arthroscopic surgery has demonstrated significant efficacy in treating FAI syndrome, with robust evidence from randomized controlled trials and systematic reviews supporting its use. Despite arthroscopic surgery's success, complications and reoperations are not uncommon. The incidence ranges from 1% to 31% and 4% to 13%, respectively. Adjunctive biologic treatments, such as bone marrow aspirate concentrates and platelet-rich plasma, have shown promise in chondral lesion management. However, robust evidence supporting their routine use in FAI syndrome is currently lacking. Among conservative treatment methods, intra-articular injections offer diagnostic and therapeutic benefits for FAI patients. While they may provide pain relief and aid in prognosis, their long-term efficacy remains a subject of debate. Comparative studies between conservative and arthroscopic treatments highlight the importance of personalized approaches in managing FAI syndrome. In conclusion, recent advancements in FAI syndrome management have illuminated various treatment modalities. Arthroscopic surgery stands as a pivotal intervention, offering substantial benefits in pain relief, function, and quality of life. However, careful patient selection and postoperative monitoring are crucial for optimizing outcomes. Adjunctive biologics and intra-articular injections show promise but require further investigation. Tailoring treatment to individual patient characteristics remains paramount in optimizing FAI syndrome management.

摘要

髋关节撞击综合征(FAI)的治疗策略随着人们对 FAI 对髋关节健康影响的认识不断提高而不断发展。早期干预,包括关节镜手术,由于其可能延缓骨关节炎的进展,因此越来越受欢迎。关节镜手术在治疗 FAI 综合征方面已被证明具有显著疗效,随机对照试验和系统评价的有力证据支持其应用。尽管关节镜手术取得了成功,但并发症和再次手术并不罕见。发生率分别为 1%至 31%和 4%至 13%。辅助生物治疗,如骨髓抽吸浓缩物和富含血小板的血浆,在软骨损伤管理中显示出希望。然而,目前缺乏支持其在 FAI 综合征中常规使用的有力证据。在保守治疗方法中,关节内注射为 FAI 患者提供了诊断和治疗益处。虽然它们可能缓解疼痛并有助于预后,但它们的长期疗效仍存在争议。保守治疗与关节镜治疗的比较研究强调了针对 FAI 综合征进行个体化治疗方法的重要性。总之,FAI 综合征管理的最新进展揭示了各种治疗模式。关节镜手术是一种关键的干预措施,在缓解疼痛、功能和生活质量方面具有显著益处。然而,仔细选择患者和术后监测对于优化结果至关重要。辅助生物制剂和关节内注射显示出希望,但需要进一步研究。根据个体患者的特点制定治疗方案仍然是优化 FAI 综合征管理的关键。

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