Yang Dongqiang, Wei Songsong, Liu Yijun, Hu Yong
Department of Orthopedics, the First Affiliated Hospital of Anhui Medical University, Hefei Anhui, 230032, P. R. China.
Department of Orthopedics, Fuyang People's Hospital, Fuyang Anhui, 236000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Dec 15;38(12):1474-1479. doi: 10.7507/1002-1892.202403052.
A prospective study was conducted to investigate the feasibility and effectiveness of three-dimensional printed guide plates assisted hip arthroscopy in the treatment of Cam-type femoroacetabular impingement (FAI).
The clinical data of 25 patients with Cam-type FAI who met the selection criteria between December 2016 and September 2022 were collected. There were 13 males and 12 females with an average age of 42 years (range, 19-66 years). The disease duration ranged from 3 to 120 months, with an average of 22.2 months. The preoperative range of internal rotation-external rotation was (28.70±4.50)°, α angle was (69.04±0.99)°, visual analogue scale (VAS) score was 6.5±0.2, and modified Harris hip score (HHS) was 50.5±0.7. All patients were treated with hip arthroscopy assisted by three-dimensional printed guide plate. The occurrence of complications was observed postoperatively, α angle of the affected hip joint was measured on Dunn X-ray film, and the glenoid labrum injury was observed by MRI. The percentage of overlap between the Cam plasty area and the preoperative simulated grinding area was calculated by three-dimensional CT+reconstruction. The effectiveness was evaluated by VAS score and modified HHS score.
Postoperative dorsalis pedis numbness occurred in 1 case, and the symptoms disappeared after 1 month of conventional drug treatment such as neurotrophy. Two cases of perineal skin injury occurred, and healed after symptomatic treatment. There was no male erectile dysfunction, deep incision infection, pulmonary embolism, or other serious complications occurred. The percentage of overlap between the Cam plasty area and the preoperative simulated grinding area was 81.6%-95.3%, with an average of 89.8%. All 25 patients were followed up 6-12 months, with an average of 8 months. At last follow-up, the range of internal rotation-external rotation was (40.10±2.98)°, α angle was (43.72±0.84)°, VAS score was 1.8±0.2, and the modified HHS score was 72.1±1.3, which significantly improved when compared with preoperative ones ( <0.05).
The treatment of Cam-type FAI with three-dimensional printed guide plates assisted hip arthroscopy is safe and feasible, and can achieve good effectiveness.
进行一项前瞻性研究，以探讨三维打印导板辅助髋关节镜治疗凸轮型股骨髋臼撞击症（FAI）的可行性和有效性。
收集2016年12月至2022年9月期间符合入选标准的25例凸轮型FAI患者的临床资料。其中男性13例，女性12例，平均年龄42岁（范围19 - 66岁）。病程3至120个月，平均22.2个月。术前内旋 - 外旋范围为（28.70±4.50）°，α角为（69.04±0.99）°，视觉模拟评分（VAS）为6.5±0.2，改良Harris髋关节评分（HHS）为50.5±0.7。所有患者均采用三维打印导板辅助髋关节镜治疗。术后观察并发症发生情况，在Dunn X线片上测量患侧髋关节α角，通过MRI观察盂唇损伤情况。通过三维CT + 重建计算凸轮成形区域与术前模拟磨削区域的重叠百分比。采用VAS评分和改良HHS评分评估疗效。
术后出现1例足背麻木，经1个月神经营养等常规药物治疗后症状消失。发生2例会阴皮肤损伤，经对症治疗后愈合。未出现男性勃起功能障碍、深部切口感染、肺栓塞等其他严重并发症。凸轮成形区域与术前模拟磨削区域的重叠百分比为81.6% - 95.3%，平均为89.8%。25例患者均获随访6 - 12个月，平均8个月。末次随访时，内旋 - 外旋范围为（40.10±2.98）°，α角为（43.72±0.84）°，VAS评分为1.8±0.2，改良HHS评分为72.1±1.3，与术前相比差异有统计学意义（<0.05）。
三维打印导板辅助髋关节镜治疗凸轮型FAI安全可行，可取得良好疗效。
