American Hip Institute Research Foundation, Chicago, Illinois, USA.
American Hip Institute, Chicago, Illinois, USA.
Am J Sports Med. 2024 Sep;52(11):2740-2749. doi: 10.1177/03635465241270291. Epub 2024 Aug 30.
Arthroscopic labral repair has been shown to result in favorable short- and midterm outcomes; however, the durability of outcomes specifically in older patients remains underreported.
To (1) report prospectively collected hip preservation rates and patient-reported outcome measures (PROMs) at a minimum 10-year follow-up in patients aged ≥40 years after primary hip arthroscopy with labral repair and (2) perform a matched analysis comparing patients aged ≥40 years with patients aged <40 years.
Cohort study; Level of evidence, 3.
Data were prospectively collected and retrospectively reviewed on all patients who underwent primary hip arthroscopy between February 2008 and December 2011. Patients aged ≥40 years who underwent labral repair were included. Preoperative and minimum 10-year follow-up scores were collected for multiple PROMs. Propensity score matching was utilized to compare these patients with a cohort of patients <40 years.
Of the 113 hips eligible, 91 hips (80.5%) on 85 patients (6 bilateral) had a minimum 10-year follow-up. There were 58 women (68%) and 27 men (32%) with a mean age and body mass index of 47.8 years and 25.8, respectively. The hip preservation rate for patients aged ≥40 years was 78%, with 20 patients requiring arthroplasty during the study period. There was significant improvement in all PROMs from baseline to minimum 10-year follow-up with high rates of achieving the minimal clinically important difference and Patient Acceptable Symptom State clinical outcome thresholds. In total, 69 patients aged ≥40 years were propensity matched to 107 patients <40 years. Patients ≥40 tended to have a lower hip preservation rate (81.2% vs 91.6%; = .06), while patients in the younger cohort had significantly higher rates of secondary hip arthroscopy (14% vs 3%; = .02). Improvement in PROMs was comparable between the groups.
Patients ≥40 years who underwent primary hip arthroscopy with labral repair demonstrated a hip preservation rate of 78%, significant and durable improvement in PROMs, and high rates of satisfaction at a minimum 10-year follow-up. Matched analysis with patients <40 years revealed comparable improvement in patient-reported outcomes between the 2 groups, with a tendency to a higher level of arthroplasty in patients ≥40 years.
关节镜下盂唇修复术已被证明可带来短期和中期的良好效果；然而，盂唇修复术在年龄较大的患者中的长期效果仍报道较少。
（1）报告≥40 岁患者行初次髋关节镜下盂唇修复术后至少 10 年的髋关节保留率和患者报告的结局测量（PROM），并（2）进行匹配分析，比较≥40 岁患者与<40 岁患者的结果。
队列研究；证据水平，3 级。
对 2008 年 2 月至 2011 年 12 月期间行初次髋关节镜手术的所有患者进行前瞻性数据收集和回顾性研究。纳入接受盂唇修复术的≥40 岁患者。收集了多个 PROM 的术前和至少 10 年的随访评分。采用倾向评分匹配法将这些患者与<40 岁的患者进行比较。
符合条件的 113 髋中，85 例患者（6 例双侧）的 91 髋有至少 10 年的随访结果。58 例女性（68%）和 27 例男性（32%），平均年龄和 BMI 分别为 47.8 岁和 25.8。≥40 岁患者的髋关节保留率为 78%，研究期间有 20 例患者需要行关节置换术。所有 PROM 从基线到至少 10 年的随访均有显著改善，达到最小临床重要差异和患者可接受的症状状态临床结果阈值的比例较高。共有 69 例≥40 岁的患者与 107 例<40 岁的患者进行了倾向评分匹配。≥40 岁组的髋关节保留率较低（81.2%比 91.6%； =.06），而年轻组的二次髋关节镜检查率显著较高（14%比 3%； =.02）。两组的 PROM 改善情况相当。
行初次髋关节镜下盂唇修复术的≥40 岁患者的髋关节保留率为 78%，PROM 显著且持久改善，至少 10 年的随访结果满意度高。与<40 岁的患者进行匹配分析显示，两组患者报告的结局改善相当，但≥40 岁组的关节置换率有增高趋势。
