Pepic Lejla, Markes Alexander R, Soriano Kylen K J, Flores Sergio E, Zhang Alan L
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, U.S.A.
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, U.S.A..
Arthroscopy. 2024 Dec 26. doi: 10.1016/j.arthro.2024.12.027.
To assess whether capsular closure during hip arthroscopy with periportal capsulotomy affects 2-year postoperative outcomes for patients with femoroacetabular impingement syndrome (FAIS) without hypermobility.
A matched-cohort retrospective analysis of a single institutional database of patients who underwent hip arthroscopy with periportal capsulotomy for management of FAIS between 2014 and 2022 was performed. Study inclusion criteria consisted of patients with FAIS who exhibited no signs of generalized ligamentous laxity (GLL) (Beighton score 0). Patients with evidence of hip osteoarthritis (Tönnis grade >1) and hip dysplasia and those undergoing revision surgery were excluded. Capsular closure was performed via a simple suture configuration through the mid-anterior portal. The capsular closure group (n = 51) was matched 1:1 by age, sex, and body mass index with the nonclosure group. Patient-reported outcome (PRO) surveys, including the Hip Disability and Osteoarthritis Outcome Score, 12-item Short-Form Survey, and visual analog scale for pain, were completed preoperatively and 2 years postoperatively. Mean score change was calculated across all PROs, and unpaired samples t tests were used to compare groups.
The overall matched cohort included 90 patients and 102 hips (age: 30.5 ± 9.5 years; body mass index: 23.3 ± 2.6; 66.7% male), with no differences in demographic or preoperative hip characteristics. Both groups achieved significant score improvements in all PROs at 2 years (P < .001), except 12-item Short-Form Survey Mental Component Summary, which remained unchanged. There was no difference in 2-year postoperative mean score change between the closure and nonclosure groups, and both groups achieved minimal clinically important difference (60.8%-84.3% vs 54.9%-86.3%), patient acceptable symptom state (60.8%-84.3% vs 52.9%-76.5%), and substantial clinical benefit (54.9%-76.5% vs 47.1%-64.7%) thresholds at similar rates across all PROs, with no complications or conversions to total hip arthroplasty, respectively.
Among patients with FAIS without hypermobility (Beighton score of 0) undergoing periportal capsulotomy during hip arthroscopy, capsular closure showed no differences in 2-year postoperative outcomes compared to nonclosure.
Level III, retrospective matched-cohort study.
评估在髋关节镜检查并进行关节囊周围切开术时进行关节囊闭合对无关节活动过度的股骨髋臼撞击综合征（FAIS）患者术后2年的疗效。
对2014年至2022年间在单一机构数据库中接受髋关节镜检查并进行关节囊周围切开术以治疗FAIS的患者进行匹配队列回顾性分析。研究纳入标准包括无全身韧带松弛（GLL）体征（Beighton评分0分）的FAIS患者。有髋关节骨关节炎（Tönnis分级>1）和髋关节发育不良证据的患者以及接受翻修手术的患者被排除。通过经前正中入路的简单缝合方式进行关节囊闭合。关节囊闭合组（n = 51）在年龄、性别和体重指数方面与非闭合组1:1匹配。术前和术后2年完成患者报告结局（PRO）调查，包括髋关节残疾和骨关节炎结局评分、12项简明调查问卷以及疼痛视觉模拟量表。计算所有PRO的平均评分变化，并使用非配对样本t检验比较组间差异。
总体匹配队列包括90例患者和102个髋关节（年龄：30.5±9.5岁；体重指数：23.3±2.6；66.7%为男性），在人口统计学或术前髋关节特征方面无差异。两组在术后2年时所有PRO的评分均有显著改善（P <.001），但12项简明调查问卷心理成分总结评分未变。闭合组和非闭合组术后2年的平均评分变化无差异，且两组在所有PRO中达到最小临床重要差异（60.8% - 84.3%对54.9% - 86.3%）、患者可接受症状状态（60.8% - 84.3%对52.9% - 76.5%）和实质性临床获益（54.9% - 76.5%对47.1% - 64.7%）阈值的比例相似，且分别无并发症或未转为全髋关节置换术。
在髋关节镜检查并进行关节囊周围切开术的无关节活动过度（Beighton评分为0）的FAIS患者中，关节囊闭合与非闭合相比，术后2年疗效无差异。
III级，回顾性匹配队列研究。
