Domb Benjamin G, Kufta Allison Y, Kingham Yasemin E, Sabetian Payam W, Harris W Taylor, Perez-Padilla Paulo A
American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
American Hip Institute, Des Plaines, Illinois, USA.
Am J Sports Med. 2025 Feb;53(2):281-290. doi: 10.1177/03635465241302806. Epub 2025 Jan 18.
Sex has been associated with different pathologic characteristics in painful hips undergoing hip arthroscopic surgery.
To compare minimum 10-year patient-reported outcomes (PROs) and survivorship in patients who underwent primary hip arthroscopic surgery for femoroacetabular impingement syndrome and labral tears according to sex.
Cohort study; Level of evidence, 3.
Data from patients who underwent primary hip arthroscopic surgery between March 2009 and May 2011 were reviewed. Patients with minimum 10-year PROs for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain were eligible. Exclusion criteria included previous ipsilateral hip conditions or surgical procedures, Tönnis grade >1, or dysplasia (lateral center-edge angle <25°). In the subanalysis, female patients were matched to male patients using a 1:1 ratio by age, sex, and body mass index.
A total of 375 hips had a minimum 10-year follow-up. There were 249 female (mean age, 36.8 ± 13.1 years) and 126 male (mean age, 38.9 ± 13.1 years) hips. Survivorship was defined as no conversion to total hip arthroplasty. Female and male hips exhibited similarly high rates of survivorship (80.3% vs 72.2%, respectively; = .076). Female hips underwent secondary arthroscopic surgery at a statistically higher rate of 14.5% ( = .021) and had higher rates of capsular repair and iliopsoas fractional lengthening ( < .0001 and < .001, respectively). Male hips had a significantly higher rate of acetabular labrum articular disruption/Outerbridge grade 3 and 4 damage at 54.0% compared with female hips (both < .001) and underwent femoroplasty and acetabular microfracture at significantly higher rates of 88.1% versus 51.0%, respectively, and 16.7% versus 4.8%, respectively (both < .001). In the subanalysis, both groups showed significant improvements in all PROs from baseline (all < .001). Even though female patients demonstrated a higher rate of secondary arthroscopic surgery, they had a higher self-reported mean satisfaction score of 9.0 compared with 8.4 ( = .003) and a greater magnitude of improvement in 10-year PROs (ΔmHHS: 29.3 ± 17.5 vs 23.1 ± 19.8, respectively [ = .036]; ΔNAHS: 33.2 ± 21.3 vs 25.1 ± 19.5, respectively [ = .012]; ΔHOS-SSS: 47.0 ± 32.0 vs 32.7 ± 31.9, respectively [ = .008]; and ΔVAS: -4.6 ± 2.7 vs -3.5 ± 2.0, respectively [ = .009]). However, all PROs at a minimum 10-year follow-up were similar between the groups.
After undergoing hip arthroscopic surgery for femoroacetabular impingement syndrome, both female and male patients reported significant improvements in all PROs at a minimum 10-year follow-up and high patient satisfaction, with similar final functional scores. Even though female patients demonstrated a higher rate of secondary arthroscopic surgery, they had a higher satisfaction score and a greater magnitude of improvement in PROs postoperatively.
在接受髋关节镜手术的疼痛性髋关节中，性别与不同的病理特征相关。
比较因股骨髋臼撞击综合征和盂唇撕裂接受初次髋关节镜手术的患者按性别分类的至少10年患者报告结局（PROs）和生存率。
队列研究；证据等级，3级。
回顾2009年3月至2011年5月间接受初次髋关节镜手术患者的数据。符合条件的患者需有至少10年的改良Harris髋关节评分（mHHS）、非关节炎髋关节评分（NAHS）、髋关节结局评分-运动特定子量表（HOS-SSS）以及疼痛视觉模拟量表（VAS）的PROs。排除标准包括既往同侧髋关节疾病或手术史、Tönnis分级>1或发育异常（外侧中心边缘角<25°）。在亚分析中，女性患者按年龄、性别和体重指数以1:1的比例与男性患者匹配。
共有375例髋关节进行了至少10年的随访。其中女性髋关节249例（平均年龄36.8±13.1岁），男性髋关节126例（平均年龄38.9±13.1岁）。生存率定义为未转换为全髋关节置换术。女性和男性髋关节的生存率相似（分别为80.3%和72.2%；P = 0.076）。女性髋关节二次关节镜手术的发生率在统计学上更高，为14.5%（P = 0.021），并且关节囊修复和髂腰肌部分延长的发生率更高（分别P<0.0001和P<0.001）。男性髋关节髋臼盂唇关节破坏/Outerbridge 3级和4级损伤的发生率显著高于女性髋关节，为54.0%（两者P<0.001），并且股骨成形术和髋臼微骨折的发生率分别显著高于女性髋关节，为88.1%对51.0%，以及16.7%对4.8%（两者P<0.001）。在亚分析中，两组所有PROs从基线开始均有显著改善（所有P<0.001）。尽管女性患者二次关节镜手术的发生率较高，但她们自我报告的平均满意度得分更高，为9.0分，而男性为8.4分（P = 0.003），并且术后10年PROs的改善幅度更大（ΔmHHS：分别为29.3±17.5对23.1±19.8 [P = 0.036]；ΔNAHS：分别为33.2±21.3对25.1±19.5 [P = 0.012]；ΔHOS-SSS：分别为47.0±32.0对32.7±31.9 [P = 0.008]；以及ΔVAS：分别为-4.6±2.
