Randelli Filippo, Mazzoleni Manuel Giovanni, Bezza Alessandro, Di Loreto Andrea, Elhiny Mohammad Mourad, Elshafie Mohamed, Fioruzzi Alberto
Hip Department (CAD), ASST Gaetano Pini-CTO, Milan, Italy.
Department of Life Health & Environmental Sciences, Unit of Orthopaedics and Traumatology, University of L'Aquila, L'Aquila, Italy.
Arthroscopy. 2025 Jun;41(6):1776-1785. doi: 10.1016/j.arthro.2024.08.012. Epub 2024 Aug 28.
To investigate the survival and durability of clinical improvements after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) at a minimum of 10-year follow-up.
Data from patients who underwent HA for FAIS between March 2003 and May 2012 were collected and retrospectively reviewed. Patients who underwent evaluation at a minimum 10-year follow-up, assessed according to the Hip Outcome Score (HOS)-Activities of Daily Living, HOS-Sport-Specific Subscale, and Non-arthritic Hip Score, were included. Satisfaction ratings were collected. Statistical analysis assessed within-group differences and survival.
This study included 95 patients with an average follow-up period of 11.8 years. The mean age was 39.5 ± 11.0 years. The overall total hip replacement (THR) conversion rate was 24.2%, with a mean time of 3.4 ± 3.2 years. Hip joint preservation surgery revision was required in 3.2% of patients at a mean of 3.2 ± 3 years. The rate of survivorship at 10 years was 72.6%. The minimal clinically important difference was achieved by 28 patients for the HOS-Activities of Daily Living (73.6%), 28 patients (75.6%) for the HOS-Sport-Specific Subscale, and 33 patients (84.6%) for the Non-arthritic Hip Score. The patient acceptable symptom state was achieved by 42 patients (61.7%), 43 patients (65.1%), and 44 patients (64.7%), respectively. Comparative analysis between patients whose hip was preserved and those who underwent hip joint preservation surgery revision or THR highlighted that Tönnis grade 2 or greater, chondrolabral junction damage, and lower preoperative scores were associated with failure.
HA for FAIS showed durable results, with an acceptable THR conversion rate and sustained clinical benefits. Of the patients whose hip was preserved, 91.3% were satisfied. Tönnis grade 2 or greater, magnetic resonance arthrography signs of chondrolabral junction damage, and lower preoperative functional status are strongly associated with failure.
Level IV, therapeutic case series.
在至少10年的随访期内，研究髋关节镜检查（HA）治疗股骨髋臼撞击综合征（FAIS）后临床改善情况的生存率和持久性。
收集2003年3月至2012年5月期间因FAIS接受HA治疗的患者数据并进行回顾性分析。纳入至少随访10年且根据髋关节结果评分（HOS）-日常生活活动、HOS-运动特定子量表和非关节炎髋关节评分进行评估的患者。收集满意度评分。进行统计学分析以评估组内差异和生存率。
本研究纳入95例患者，平均随访期为11.8年。平均年龄为39.5±11.0岁。总体全髋关节置换（THR）转换率为24.2%，平均时间为3.4±3.2年。3.2%的患者需要进行髋关节保留手术翻修，平均时间为3.2±3年。10年时的生存率为72.6%。28例患者（73.6%）在HOS-日常生活活动方面、28例患者（75.6%）在HOS-运动特定子量表方面以及33例患者（84.6%）在非关节炎髋关节评分方面达到最小临床重要差异。分别有42例患者（61.7%）、43例患者（65.1%）和44例患者（64.7%）达到患者可接受的症状状态。对髋关节得以保留的患者与接受髋关节保留手术翻修或THR的患者进行比较分析发现，Tönnis分级为2级或更高、软骨盂唇交界处损伤以及术前评分较低与治疗失败相关。
HA治疗FAIS显示出持久的效果，THR转换率可接受且临床获益持续。在髋关节得以保留的患者中，91.3%表示满意。Tönnis分级为2级或更高、软骨盂唇交界处损伤的磁共振关节造影征象以及术前功能状态较低与治疗失败密切相关。
IV级，治疗性病例系列。
