Munim Mohammed A, Samuel Linsen T, Rosneck James T, Kamath Atul F
School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Department of Orthopaedic Surgery, Orthopaedic & Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
HSS J. 2024 Nov;20(4):577-588. doi: 10.1177/15563316231183093. Epub 2023 Jul 17.
Studies on the feasibility of hip arthroscopy in workers' compensation (WC) patients have been largely inconsistent or limited by study design, necessitating the need for a systematic review.
We sought to systematically compare clinically significant differences between WC patients and their counterparts in relation to (1) functional outcomes, (2) complications, and (3) failure rates after hip arthroscopy.
We searched MEDLINE, EMBASE, and PubMed databases for studies published between January 1996 and February 2021. In combination with "AND" or "OR" Boolean operators, the following keywords were implemented: "hip arthroscopy," "workers' compensation," "outcomes," "complications," "revision," and "failure rates." Two reviewers screened eligible studies, evaluated methodological quality, and abstracted data.
In the 13 studies pooled, comprising 1874 patients, 276 (14.7%) patients received WC benefits. Twelve studies utilized functional outcomes, 2 studies assessed pain, and 3 studies evaluated satisfaction. Despite scoring lower in these measures preoperatively, WC patients demonstrated significant improvements after hip arthroscopy. Three studies linked compensation with marginally inferior functional scores, but this association was not significant at longer follow-up. Seven studies examined complication incidence, and 6 studies addressed failure rates, with all reporting no significant differences in rates of complications, secondary arthroscopies, or conversion to total hip arthroplasty.
The findings of this systematic review suggest that hip arthroscopy offers clinically significant benefits, regardless of WC status. Postoperative results in WC patients, including functional scores, pain, satisfaction, complications, and failure rates, were favorable, and the degree of improvement was at least comparable with their counterparts. Further studies should consider prospective study designs with larger cohorts and extended follow-up.
关于髋关节镜检查在工伤赔偿（WC）患者中的可行性研究结果大多不一致，或受研究设计限制，因此有必要进行系统评价。
我们试图系统比较WC患者与其对照者在以下方面的临床显著差异：（1）功能结局；（2）并发症；（3）髋关节镜检查后的失败率。
我们检索了MEDLINE、EMBASE和PubMed数据库，查找1996年1月至2021年2月发表的研究。结合“AND”或“OR”布尔运算符，使用了以下关键词：“髋关节镜检查”、“工伤赔偿”、“结局”、“并发症”、“翻修”和“失败率”。两名 reviewers筛选符合条件的研究，评估方法学质量并提取数据。
在汇总的13项研究中，共1874例患者，其中276例（14.7%）患者获得WC福利。12项研究使用了功能结局，2项研究评估了疼痛，3项研究评估了满意度。尽管WC患者术前在这些指标上得分较低，但髋关节镜检查后有显著改善。3项研究将赔偿与略低的功能评分相关联，但在更长时间的随访中，这种关联并不显著。7项研究检查了并发症发生率，6项研究涉及失败率，所有研究均报告并发症、二次关节镜检查或转为全髋关节置换术的发生率无显著差异。
本系统评价的结果表明，无论WC状态如何，髋关节镜检查都具有临床显著益处。WC患者的术后结果，包括功能评分、疼痛、满意度、并发症和失败率，都很理想，改善程度至少与对照者相当。进一步的研究应考虑采用前瞻性研究设计，纳入更大的队列并延长随访时间。
