关节镜治疗髋关节发育不良边缘患者的回顾性研究。
A retrospective study of arthroscopic treatment for patients with bordline developmental dysplasia of the hip.
机构信息
Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin University, Tianjin, China.
Graduate School of Tianjin University, Tianjin University, Tianjin, China.
出版信息
Int Orthop. 2024 Nov;48(11):2843-2852. doi: 10.1007/s00264-024-06300-7. Epub 2024 Sep 9.
PURPOSE
Hip arthroscopy is effective in treating bordline developmental dysplasia of the hip (BDDH), but there are only a few clinical reports in China, and its postoperative failure rate is still a problem that cannot be ignored. The aim of this study was to analyze the clinical effect of hip arthroscopy in BDDH treatment in China and to explore the risk factors influencing the efficacy of hip arthroscopy in BDDH treatment.
METHODS
All of 22 cases of BDDH treated with arthroscopy in our hospital from November March 2017 to February 2022 were analyzed retrospectively, including ten males and 12 females, with an average age of 34.7 ± 9.5 years (19-53 years). All patients underwent arthroscopic treatment with acetabular plasty, labral repair, femoral osteoplasty, and capsular plication. Visual Analogue Scale (VAS), modified Harris Hip Scores (mHHS), Hip Outcome Score-activities of Daily Living (HOS-ADL) and International Hip Outcome Tool-12 (iHOT-12) were measured before operation and at the follow-up, and statistical analysis was performed. The Minimum clinically significant difference (MCID) and Patient Acceptable Symptom State (PASS) were also obtained.
RESULTS
22 patients were followed up, and the follow-up time was ≥ one year, with an average of 21.4 ± 8.2 months. The VAS score decreased from 5.27 ± 1.58 points before surgery to 1.96 ± 0.92 points at the follow-up, and the difference was statistically significant (t = 9.05,P < 0.001). The mHHS score increased from 64.84 ± 13.58 points before surgery to 90.4 ± 10.11 points at the follow-up, and the difference was statistically significant (t=-7.07, P < 0.001). The HOS-ADL score increased from 68.92 ± 11.76 points before surgery to 88.91 ± 9.51 points at the follow-up, and the difference was statistically significant (t=-8.15,P < 0.001). The iHOT-12 score increased from 49.32 ± 12.01 points before surgery to 79.61 ± 15.89 points at the follow-up, and the difference was statistically significant (t=-7.66,P < 0.001). The MCID (mHHS) and MCID (HOS-ADL) were 81.8% and 77.3% respectively, and the PASS (mHHS) and PASS (HOS-ADL) were 86.4% and 72.7% respectively at the follow-up.
CONCLUSION
Hip arthroscopy can achieve good short-term outcomes in the treatment of BDDH.
LEVEL OF EVIDENCE
IV Therapeutic Study.
目的
髋关节镜在治疗发育性髋关节发育不良（BDDH）中是有效的，但在中国仅有少数临床报告，其术后失败率仍是一个不容忽视的问题。本研究旨在分析髋关节镜治疗 BDDH 的临床效果，并探讨影响髋关节镜治疗 BDDH 疗效的危险因素。
方法
回顾性分析我院 2017 年 11 月至 2022 年 2 月采用髋关节镜治疗的 22 例 BDDH 患者的临床资料，其中男 10 例，女 12 例，平均年龄 34.7±9.5 岁（19~53 岁）。所有患者均采用髋臼成形术、盂唇修复术、股骨截骨术和关节囊紧缩术进行关节镜治疗。术前和随访时采用视觉模拟评分（VAS）、改良 Harris 髋关节评分（mHHS）、髋关节功能评分-日常生活活动（HOS-ADL）和国际髋关节评分 12 项（iHOT-12）进行评估，并进行统计学分析。还获得了最小临床重要差异（MCID）和患者可接受症状状态（PASS）。
结果
22 例患者获得随访，随访时间≥1 年，平均 21.4±8.2 个月。VAS 评分由术前的 5.27±1.58 分降至随访时的 1.96±0.92 分，差异具有统计学意义（t=9.05，P<0.001）。mHHS 评分由术前的 64.84±13.58 分增至随访时的 90.4±10.11 分，差异具有统计学意义（t=-7.07，P<0.001）。HOS-ADL 评分由术前的 68.92±11.76 分增至随访时的 88.91±9.51 分，差异具有统计学意义（t=-8.15，P<0.001）。iHOT-12 评分由术前的 49.32±12.01 分增至随访时的 79.61±15.89 分，差异具有统计学意义（t=-7.66，P<0.001）。随访时的 MCID（mHHS）和 MCID（HOS-ADL）分别为 81.8%和 77.3%，PASS（mHHS）和 PASS（HOS-ADL）分别为 86.4%和 72.7%。
结论
髋关节镜治疗 BDDH 可获得良好的短期疗效。
证据水平
IV 级治疗性研究。
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