Celiksoz Aytek Huseyin, Bayram Berhan, Yozgatli Tahir Koray, Yilmaz Edip, Yassin Ali, Kayaalp Asim, Kocaoglu Baris
Department of Orthopaedics and Traumatology, Eskisehir City Hospital, Eskisehir, Turkey.
Department of Orthopaedics and Traumatology, Acibadem Altunizade Hospital, Istanbul, Turkey.
Orthop J Sports Med. 2024 Aug 29;12(8):23259671241265737. doi: 10.1177/23259671241265737. eCollection 2024 Aug.
Both knotless and knot-tying anchors are commonly employed in the arthroscopic repair of hip labral tears.
To compare the midterm clinical results of arthroscopic hip labral repair using knot-tying versus knotless suture anchors.
Cohort study; Level of evidence, 3.
Patients who underwent arthroscopic hip labral repair between January 2017 and January 2021 and who had at least 2 years of follow-up were included. The patients were divided into 2 groups based on the suture anchor type: a 2.9-mm knotless suture anchor (knotless group) or a 1.8-mm knot-tying suture anchor (knot-tying group). All patients underwent femoroplasty for cam lesions and acetabular rim trimming for pincer lesions. The modified Harris Hip Score (mHHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), 12-item International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain were administered both preoperatively and postoperatively. The consistency of the outcome scores was assessed using the minimal clinically important difference and Patient Acceptable Symptom State. The statistical significance between groups was evaluated using the Mann-Whitney test and quantile-based analysis of variance.
A total of 413 patients were included: 256 patients in the knotless group (median age, 35 years [interquartile range, 31-38 years]; median follow-up, 34 months) and 157 patients in the knot-tying group (median age, 34 years [interquartile range, 30-38 years]; median follow-up, 25 months). There were no significant differences in postoperative mHHS, HOS-ADL, or iHOT-12 scores between the 2 groups. However, there were significant differences, favoring the knotless group over the knot-tying group, in postoperative HOS-SSS (87 ± 2 vs 86 ± 1, respectively) and VAS pain (1 vs 2, respectively) scores ( < .0001 for both). Postoperative synovitis was found in significantly more patients in the knot-tying group than in the knotless group (17 vs 5, respectively; = .01).
In this study, patients who underwent arthroscopic hip labral repair with knotless suture anchors had slightly better postoperative HOS-SSS and VAS pain scores and a lower incidence of postoperative synovitis compared with patients who underwent repair with knot-tying suture anchors.
无结锚钉和打结锚钉在髋关节盂唇撕裂的关节镜修复中均被广泛应用。
比较使用打结与无结缝合锚钉进行关节镜下髋关节盂唇修复的中期临床结果。
队列研究；证据等级，3级。
纳入2017年1月至2021年1月期间接受关节镜下髋关节盂唇修复且至少随访2年的患者。根据缝合锚钉类型将患者分为两组：2.9毫米无结缝合锚钉组（无结组）或1.8毫米打结缝合锚钉组（打结组）。所有患者均接受针对凸轮病变的股骨成形术和针对钳夹病变的髋臼边缘修整术。术前和术后均采用改良Harris髋关节评分（mHHS）、髋关节功能评分-运动特定子量表（HOS-SSS）、髋关节功能评分-日常生活活动（HOS-ADL）、12项国际髋关节功能工具（iHOT-12）以及疼痛视觉模拟量表（VAS）进行评估。使用最小临床重要差异和患者可接受症状状态评估结果评分的一致性。采用Mann-Whitney检验和基于分位数的方差分析评估两组之间的统计学显著性。
共纳入413例患者：无结组256例（中位年龄35岁[四分位间距，31 - 38岁]；中位随访34个月），打结组157例（中位年龄34岁[四分位间距，30 - 38岁]；中位随访25个月）。两组术后mHHS、HOS-ADL或iHOT-12评分无显著差异。然而，术后HOS-SSS评分（分别为87±2和86±1）和VAS疼痛评分（分别为1和2）存在显著差异，无结组优于打结组（两者均P <.0001）。打结组术后滑膜炎患者显著多于无结组（分别为17例和5例；P =.01）。
在本研究中，与使用打结缝合锚钉进行修复的患者相比，使用无结缝合锚钉进行关节镜下髋关节盂唇修复的患者术后HOS-SSS和VAS疼痛评分略优，且术后滑膜炎发生率较低。
