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针对股骨髋臼撞击症进行手术性髋关节脱位后的六个月康复,可恢复除外旋肌外的大多数髋部肌肉的术前力量。

Six-month rehabilitation following surgical hip dislocation for femoroacetabular impingement restores the preoperative strength of most hip muscles, except for external rotators.

作者信息

Servant Guillaume, Bothorel Hugo, Pernoud Anthony, Mayes Susan, Fourchet François, Christofilopoulos Panayiotis

机构信息

Physiotherapy Department and Motion Analysis Lab, Swiss Olympic Medical Center, La Tour Hospital, Av. J.-D.-Maillard 3, Meyrin 1217, Switzerland.

Research department, La Tour Hospital, Av. J.-D.-Maillard 3, Meyrin 1217, Switzerland.

出版信息

J Hip Preserv Surg. 2024 Dec 19;12(1):46-53. doi: 10.1093/jhps/hnae042. eCollection 2025 Jan.

Abstract

The aim of this study was to evaluate the bilateral changes in hip muscle strength after a 6-month rehabilitation period for patients undergoing surgical hip dislocation (SHD) to treat femoroacetabular impingement syndrome (FAIS). We conducted a retrospective analysis on a cohort of 22 patients (mean ± SD age: 26 ± 7, 68% male) who underwent SHD for FAIS between March 2020 and January 2023 at La Tour Hospital. Bilateral isometric strength of eight hip muscle groups (abductors, adductors, hamstrings, quadriceps, extensors, flexors, internal, and external rotators) was assessed using a handheld dynamometer before surgery, and at 3 and 6 months postoperatively. After 6 months of rehabilitation, only the external rotators were weaker compared to preoperative levels (-13% ± 23%,  = .021). Strength levels were similar to preoperative levelsfor adductors (-2% ± 21%,  = .309), internal rotators (0% ± 25%,  = .444), quadriceps (0%± 23%,  = .501), hamstrings (7%± 20%,  = .232), extensors (7%± 19%,  = .336), flexors (8%± 34%,  = .781), and abductors (8% ± 25%,  = .266). At 6 months, 59% (abductors) to 82% (adductors) of patients did not achieve a clinically relevant strength improvement (>15%) compared to their preoperative status for aforementioned muscles. Additionally, 50% of the cohort experienced a clinically relevant loss of strength in the external rotators at 6 months post-surgery. To conclude, after SHD, most FAIS patients regained their preoperative strength for all muscle groups except the external rotators with a 6-month rehabilitation program. However, the effectiveness of the rehabilitation protocol varies on an individual level.

摘要

本研究的目的是评估接受手术性髋关节脱位(SHD)治疗股骨髋臼撞击综合征(FAIS)的患者在6个月康复期后的双侧髋部肌肉力量变化。我们对2020年3月至2023年1月在拉图尔医院因FAIS接受SHD手术的22例患者(平均年龄±标准差:26±7岁,68%为男性)进行了回顾性分析。在手术前、术后3个月和6个月,使用手持测力计评估八个髋部肌肉群(外展肌、内收肌、腘绳肌、股四头肌、伸肌、屈肌、内旋肌和外旋肌)的双侧等长肌力。经过6个月的康复训练,与术前水平相比,只有外旋肌力量减弱(-13%±23%,P = 0.021)。内收肌(-2%±21%,P = 0.309)、内旋肌(0%±25%,P = 0.444)、股四头肌(0%±23%,P = 0.501)、腘绳肌(7%±20%,P = 0.232)、伸肌(7%±19%,P = 0.336)、屈肌(8%±34%,P = 0.781)和外展肌(8%±25%,P = 0.266)的力量水平与术前相似。在6个月时,与术前状态相比,59%(外展肌)至82%(内收肌)的患者上述肌肉未实现临床上相关的力量改善(>15%)。此外,50%的队列患者在术后6个月时外旋肌出现临床上相关的力量丧失。总之,SHD术后,除外旋肌外,大多数FAIS患者通过6个月的康复计划恢复了术前所有肌肉群的力量。然而,康复方案的有效性在个体水平上存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c67/12051858/7c48c086242e/hnae042f1.jpg

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本文引用的文献

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Hip Arthroscopy Followed by 6-Month Rehabilitation Leads to Improved Periarticular Muscle Strength, Except for Abductors and External Rotators.
Arthrosc Sports Med Rehabil. 2024 Jan 24;6(2):100900. doi: 10.1016/j.asmr.2024.100900. eCollection 2024 Apr.
2
Open and arthroscopic management of femoroacetabular impingement: a review of current concepts.
J Hip Preserv Surg. 2022 Oct 13;9(4):265-275. doi: 10.1093/jhps/hnac043. eCollection 2022 Dec.
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Arthroscopic surgery versus physiotherapy for femoroacetabular impingement: a meta-analysis study.
Eur J Orthop Surg Traumatol. 2020 Oct;30(7):1151-1162. doi: 10.1007/s00590-020-02675-6. Epub 2020 May 7.

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