Karlsson Louise, Collberg Olle, Erlandsson David, Nikou Sarantos, Baranto Adad, Öhlin Axel, Lindman Ida
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
Orthop J Sports Med. 2024 Oct 21;12(10):23259671241275657. doi: 10.1177/23259671241275657. eCollection 2024 Oct.
Arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) has previously been reported to have favorable short-term results in high-level athletes. Less is known about long-term outcomes.
To report outcomes 10 years after hip arthroscopy for FAIS in high-level athletes using validated patient-reported outcome measures (PROMs).
Case series; Level of evidence, 4.
Patients who underwent hip arthroscopy between November 2011 and January 2013 were included in a local hip arthroscopy registry and completed preoperative PROMs. At 10-year follow-up, the same PROMs were completed. Inclusion criteria were age <40 years at time of surgery, no prior hip surgeries, and a pre-symptomatic Hip Sports Activity Scale (HSAS) level of 7 or 8. The exclusion criterion was total hip arthroplasty at follow-up. The PROMs included the international Hip Outcome Tool-12 items (iHOT-12), the Copenhagen Hip and Groin Outcome Score (HAGOS), visual analog scale (VAS) for overall hip function, European Quality of Life-5 Dimensions questionnaire (EQ-5D) and European Quality of Life-visual analog scale (EQ-VAS), HSAS, and a single question on patient satisfaction. The rates of patients achieving minimal important change and reporting Patient Acceptable Symptom State (PASS) were reported for HAGOS and iHOT-12. For iHOT-12, preoperative results were compared with 1, 5, and 10-year follow-ups.
A total of 45 patients (34 men, 11 women; 70 hips; mean age 24.4 years at time of surgery) were included, with 77 patients eligible for inclusion. Significant improvements ( < .001) were seen at 10-year follow-up in all HAGOS subscales: Symptoms, Pain, Daily Activity, Sports, Physical Activity, Quality of Life (50.3 vs 78.6, 59.2 vs 86.8, 65.9 vs 88.8, 37.1 vs 81.1, 24.4 vs 81.1, 32.1 vs 79.3), iHOT-12 (40.1 vs 81.6), EQ-5D (0.59 vs 0.89), EQ-VAS (65.6 vs 80.4), and VAS for overall hip function (48 vs 79). For iHOT-12, the largest change was seen between preoperative and 1-year follow-up values, with consistent results over time. There was no statistically significant difference between HSAS levels preoperatively and at 10-year follow-up (HSAS level 4), with 24% of patients reporting a HSAS level 7 or 8 at the follow-up. Of the patients, 93% reported satisfaction with the surgery. PASS was achieved in 82% for iHOT-12, with a range of 76% to 91% for HAGOS subscales. Furthermore, 93% exceeded the minimal important change for iHOT-12, and a range of 67% to 84% for HAGOS.
In a high-level athletic population, significant improvements in long-term outcomes are reported after hip arthroscopy for FAIS, with patients reporting a high satisfaction rate. The results also show that the largest improvement occurs within the first postoperative year, with results being maintained for 10 years.
先前有报道称，关节镜治疗股骨髋臼撞击综合征（FAIS）在高水平运动员中具有良好的短期效果。关于长期疗效的了解较少。
使用经过验证的患者报告结局测量指标（PROMs），报告高水平运动员髋关节镜治疗FAIS 10年后的疗效。
病例系列；证据等级，4级。
2011年11月至2013年1月接受髋关节镜手术的患者被纳入当地髋关节镜登记处，并完成术前PROMs。在10年随访时，完成相同的PROMs。纳入标准为手术时年龄<40岁，既往无髋关节手术史，症状前髋关节运动活动量表（HSAS）评分为7或8。排除标准为随访时行全髋关节置换术。PROMs包括国际髋关节结局工具-12项（iHOT-12）、哥本哈根髋关节和腹股沟结局评分（HAGOS）、髋关节整体功能视觉模拟量表（VAS）、欧洲生活质量-5维度问卷（EQ-5D）和欧洲生活质量-视觉模拟量表（EQ-VAS）、HSAS，以及一个关于患者满意度的单一问题。报告了HAGOS和iHOT-12达到最小重要变化和报告患者可接受症状状态（PASS）的患者比例。对于iHOT-12，将术前结果与1年、5年和10年随访结果进行比较。
共纳入45例患者（34例男性，11例女性；70髋；手术时平均年龄24.4岁），77例患者符合纳入标准。在10年随访时，所有HAGOS子量表均有显著改善（P<0.001）：症状、疼痛、日常活动、运动、身体活动、生活质量（50.3对78.6、59.2对86.8、65.9对88.8、37.1对81.1、24.4对81.1、32.1对79.3）、iHOT-12（40.1对81.6）、EQ-5D（0.59对0.89）、EQ-VAS（65.6对80.4）以及髋关节整体功能VAS（48对79）。对于iHOT-12，术前与1年随访值之间的变化最大，且随时间结果一致。术前与10年随访时的HSAS水平无统计学显著差异（HSAS评分为4），24%的患者在随访时报告HSAS评分为7或8。93%的患者报告对手术满意。iHOT-12的PASS达到率为82%，HAGOS子量表的PASS达到率为76%至91%。此外，93%的患者超过了iHOT-12的最小重要HAGOS的最小重要变化。
在高水平运动员群体中，髋关节镜治疗FAIS后的长期疗效有显著改善，患者报告满意度高。结果还表明，最大改善发生在术后第一年，且结果维持10年。
