Maldonado David R, Bruning Rachel E, Nerys-Figueroa Julio, Domb Benjamin G
Department of Orthopedic Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA.
American Hip Institute Research Foundation, Des Plaines, Illinois, USA.
Orthop J Sports Med. 2025 May 20;13(5):23259671251326447. doi: 10.1177/23259671251326447. eCollection 2025 May.
Anatomic labral repair is paramount when restoring the hip suction sealing mechanism in femoroacetabular impingement syndrome (FAIS) surgery. All-suture knotless tensionable anchors have been recently proposed as an alternative; however, data are scarce.
To report patient-reported outcome measure (PROM) scores at a minimum 2-year follow-up for patients who underwent primary hip arthroscopic surgery with labral repair using an all-suture knotless tensionable anchor with the controlled-tension anatomic technique in the setting of FAIS.
Case series; Level of evidence, 4.
Data were prospectively collected, and patients who underwent primary hip arthroscopic surgery for the treatment of FAIS and labral tears using an all-suture knotless tensionable anchor with the controlled-tension anatomic technique between April 2019 and February 2021 were included. Patients were excluded if they had previous ipsilateral hip conditions or surgery, Tönnis grade >1, or workers' compensation insurance. Baseline and minimum 2-year follow-up scores for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, International Hip Outcome Tool-12 (iHOT-12), and patient satisfaction were collected. Rates of achieving the minimal clinically important difference (MCID), the Patient Acceptable Symptomatic State (PASS), and the maximum outcome improvement (MOI) as well as the rate of secondary procedures were reported. Survivorship was defined as no conversion to total hip arthroplasty.
A total of 200 patients (200 hips) were included for analysis with a minimum 2-year follow-up. There were 141 female (70.5%) and 59 male (29.5%) patients with a mean age and mean body mass index of 33.3 ± 13.5 years and 24.5 ± 4.8 kg/m, respectively. A significant improvement on all PROMs from baseline to a minimum 2-year follow-up was reported ( < .05). The cohort demonstrated high rates of achieving the MCID for the mHHS (91.0%), NAHS (92.0%), HOS-SSS (93.5%), and VAS (92.5%); high rates of achieving the PASS for the mHHS (80.5%), NAHS (73.0%), and HOS-SSS (77.0%); and high rates of achieving the MOI for the NAHS (74.5%) and HOS-SSS (76.5%), with 95.5% of patients achieving the MCID or PASS for at least 1 metric. The survivorship rate at a minimum 2-year follow-up was 97.5%, and 4.0% of patients underwent subsequent revision hip arthroscopic surgery at a mean of 31.4 months.
At a minimum 2-year follow-up, patients who underwent primary hip arthroscopic surgery for FAIS with labral tears using an all-suture knotless tensionable anchor demonstrated a significant improvement on all the PROMs examined. Moreover, high achievement rates of the MCID, PASS, and MOI were reported. Based on this prospective analysis, labral repair using an all-suture knotless tensionable anchor seems to be a safe and valid option.
在股骨髋臼撞击综合征（FAIS）手术中恢复髋关节的吸持密封机制时，解剖学上的盂唇修复至关重要。最近有人提出使用全缝线无结可张紧锚钉作为一种替代方法；然而，相关数据很少。
报告在FAIS背景下，采用全缝线无结可张紧锚钉及可控张力解剖技术进行初次髋关节镜手术并盂唇修复的患者，在至少2年随访期的患者报告结局测量（PROM）评分。
病例系列；证据等级，4级。
前瞻性收集数据，纳入2019年4月至2021年2月期间采用全缝线无结可张紧锚钉及可控张力解剖技术进行初次髋关节镜手术治疗FAIS和盂唇撕裂的患者。如果患者既往有同侧髋关节疾病或手术史、Tönnis分级>1或有工伤赔偿保险，则将其排除。收集改良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）、疼痛视觉模拟量表（VAS）、国际髋关节结局工具-12（iHOT-12）的基线和至少2年随访评分以及患者满意度。报告达到最小临床重要差异（MCID）、患者可接受症状状态（PASS）和最大结局改善（MOI）的比率以及二次手术的比率。生存率定义为未转换为全髋关节置换术。
共纳入200例患者（200髋）进行分析，随访至少2年。有141例女性（70.5%）和59例男性（29.5%）患者，平均年龄和平均体重指数分别为(33.3±13.5)岁和(24.5±4.8)kg/m²。报告显示从基线到至少2年随访时所有PROM均有显著改善（P<0.05）。该队列实现mHHS的MCID（91.0%）、NAHS的MCID（92.0%）、HOS-SSS的MCID（93.5%）和VAS的MCID（92.5%）的比率较高；实现mHHS的PASS（80.5%）、NAHS的PASS（73.0%）和HOS-SSS的PASS（77.0%）的比率较高；实现NAHS的MOI（74.5%）和HOS-SSS的MOI（76.5%）的比率较高，95.5%的患者至少在1项指标上达到MCID或PASS。至少2年随访时的生存率为97.5% [1]，4.0%的患者平均在31.4个月后接受了后续的髋关节镜翻修手术。
在至少2年随访时，采用全缝线无结可张紧锚钉对FAIS伴盂唇撕裂进行初次髋关节镜手术的患者，在所有检查的PROM上均有显著改善。此外，报告显示MCID、PASS和MOI的达成率较高。基于这项前瞻性分析，使用全缝线无结可张紧锚钉进行盂唇修复似乎是一种安全有效的选择。 [1]注：此处生存率原文97.5%后疑似缺单位，译文保留原文格式以便读者理解。
