Shen Lin-Yi, Li Qian-Ru, Li Wei-Xing, Chen Kai-Zhe, Li Hong-Yun
Department of Sports Medicine and Arthroscopic Surgery, Sports Medical Center of Fudan University, Huashan Hospital, Fudan University, Shanghai, China.
Orthop J Sports Med. 2025 Apr 18;13(4):23259671251330289. doi: 10.1177/23259671251330289. eCollection 2025 Apr.
The capacity of an unrepaired joint capsule to heal after primary hip arthroscopic surgery in patients with femoroacetabular impingement syndrome (FAIS) remains uncertain. The factors that may contribute to nonhealing of the joint capsule are yet to be elucidated.
To report the healing rate of the unrepaired joint capsule after primary hip arthroscopic surgery and to identify factors that may contribute to nonhealing.
Case-control study; Level of evidence, 3.
Data collected between August 2015 and October 2023 were reviewed. Patients with FAIS aged 18 to 65 years who underwent hip arthroscopic surgery without capsule repair and had a minimum 6-month follow-up were included. Patient demographic data were collected including age at the time of surgery, sex, body mass index, laterality of the affected hip, follow-up duration, FAIS type, and intraoperative procedures. Capsule thickness was measured on preoperative magnetic resonance imaging. The status of capsule healing was evaluated on magnetic resonance imaging at least 6 months after surgery. The correlation between an unhealed capsule and various clinical factors was also evaluated.
A total of 64 patients (66 hips) were included for analysis (48 hips in the healed group and 18 hips in the unhealed group). Age (44.50 ± 11.36 vs 38.44 ± 10.52 years, respectively; = .045) and preoperative anterior capsule thickness (3.02 ± 0.87 vs 3.64 ± 1.01 mm, respectively; = .025) were significantly different between the unhealed and healed groups. Other patient characteristics did not significantly differ between the groups. Higher age (ρ = -0.247; = .045) and thinner anterior capsule (ρ = 0.276; = .025) were associated with unhealed capsules. Receiver operating characteristic curve analysis showed that the optimal cut-off value for anterior capsule thickness to discriminate between healed and unhealed capsules was 3.35 mm, with a sensitivity and specificity of 0.667 and 0.667, respectively. The optimal cut-off value for age was 43 years, with a sensitivity and specificity of 0.667 and 0.604, respectively.
At a minimum 6-month follow-up, 27.2% of patients with FAIS who underwent primary arthroscopic surgery had unhealed anterior hip capsules. Both higher age and lower preoperative anterior hip capsule thickness may affect capsule healing in patients with FAIS who undergo primary arthroscopic surgery without capsule repair.
在股骨髋臼撞击综合征（FAIS）患者中，初次髋关节镜手术后未修复的关节囊的愈合能力仍不确定。可能导致关节囊不愈合的因素尚待阐明。
报告初次髋关节镜手术后未修复关节囊的愈合率，并确定可能导致不愈合的因素。
病例对照研究；证据等级，3级。
回顾2015年8月至2023年10月期间收集的数据。纳入年龄在18至65岁之间、接受了髋关节镜手术但未进行关节囊修复且至少随访6个月的FAIS患者。收集患者的人口统计学数据，包括手术时的年龄、性别、体重指数、患侧髋关节、随访时间、FAIS类型和术中操作。术前通过磁共振成像测量关节囊厚度。在术后至少6个月通过磁共振成像评估关节囊的愈合情况。还评估了未愈合关节囊与各种临床因素之间的相关性。
共有64例患者（66髋）纳入分析（愈合组48髋，未愈合组18髋）。未愈合组和愈合组之间的年龄（分别为44.50±11.36岁和38.44±10.52岁；P = 0.045）和术前前关节囊厚度（分别为3.02±0.87 mm和3.64±1.01 mm；P = 0.025）存在显著差异。其他患者特征在两组之间无显著差异。年龄较大（ρ = -0.247；P = 0.045）和前关节囊较薄（ρ = 0.276；P = 0.025）与关节囊未愈合相关。受试者工作特征曲线分析显示，区分愈合和未愈合关节囊的前关节囊厚度的最佳截断值为3.35 mm，敏感性和特异性分别为0.667和0.667。年龄的最佳截断值为43岁，敏感性和特异性分别为0.667和0.604。
在至少6个月的随访中，接受初次关节镜手术的FAIS患者中有27.2%的患者前髋关节囊未愈合。年龄较大和术前前髋关节囊厚度较低均可能影响接受初次关节镜手术且未进行关节囊修复的FAIS患者的关节囊愈合。
