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青少年股骨髋臼撞击综合征的关节镜手术:一项系统评价和荟萃分析

Arthroscopic Procedure for Femoroacetabular Impingement Syndrome in Adolescents: A Systematic Review and Meta-analysis.

作者信息

Rathore Sameer, Mehta Sonu, Rai Avinash, Mohammed Faisal

机构信息

Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, UK.

Department of Trauma and Orthopaedics, Glan Clwyd Hospital, Rhyl, UK.

出版信息

Hip Pelvis. 2025 Jun 1;37(2):87-102. doi: 10.5371/hp.2025.37.2.87.

Abstract

Femoroacetabular impingement (FAI) is caused by aberrant anatomy involving the proximal femur with or without the acetabulum resulting in mechanical impingement. FAI's effects can be devastating in the young. In recent studies, significant associations have been found between skeletal immaturity, FAI, and sports involvement. Hip arthroscopy for FAI has been demonstrated to produce good results. We opted to update the review and meta-analysis to further narrow the research gap in the literature by including recently published studies and a comprehensive review of the arthroscopic approach for FAI. Prior to January 1, 2024, PubMed, Embase, and Google Scholar databases were searched for the studies with data on surgical procedures and patient-related outcomes for arthroscopic FAI. RevMan 5.2 was utilized to calculate the pooled mean differences with a 95% confidence interval to compare reported postoperative and preoperative patients' outcomes. In total, 24 studies of adolescent subjects with a mean age of less than 20 years, including 1,619 patients and 1,767 hips, were included. Eleven studies included acetabuloplasty and femoroplasty as major treatments. When preoperative and postoperative outcomes were compared, statistically significant changes were seen in the mHHS (modified Harris hip score), HOS-ADL (Hip Outcome Score-Activities of Daily Living), HOS-SSS (Hip Outcome Score-Sports-Specific Subscale), i-HOT (International Hip Outcome Tool 12 questions), NAHS (Nonarthritic Hip Score), and the visual analog scale. Numbness, neuropraxia and infections were seen in only 12 patients. This meta-analysis demonstrated overall improvements in hip pain, quality of life, and hip function along with few complications.

摘要

股骨髋臼撞击症(FAI)是由涉及股骨近端的异常解剖结构引起的,无论髋臼是否受累,都会导致机械性撞击。FAI对年轻人的影响可能是毁灭性的。在最近的研究中,发现骨骼未成熟、FAI和运动参与之间存在显著关联。已证明髋关节镜治疗FAI能产生良好效果。我们选择更新综述和荟萃分析,通过纳入最近发表的研究以及对FAI关节镜手术方法的全面综述,进一步缩小文献中的研究差距。在2024年1月1日前,检索了PubMed、Embase和谷歌学术数据库,以查找有关关节镜下FAI手术程序和患者相关结局的数据的研究。使用RevMan 5.2计算合并平均差异及95%置信区间,以比较报告的术后和术前患者结局。总共纳入了24项针对平均年龄小于20岁的青少年受试者的研究,包括1619例患者和1767个髋关节。11项研究将髋臼成形术和股骨成形术作为主要治疗方法。比较术前和术后结局时,改良Harris髋关节评分(mHHS)、髋关节功能评分-日常生活活动(HOS-ADL)、髋关节功能评分-运动特定子量表(HOS-SSS)、国际髋关节结局工具12题版(i-HOT)、非关节炎髋关节评分(NAHS)和视觉模拟量表有统计学意义的变化。仅12例患者出现麻木、神经失用和感染。这项荟萃分析表明,髋关节疼痛、生活质量和髋关节功能总体上有所改善,且并发症较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47bb/12120486/c460e70cd194/hp-37-2-87-f5.jpg

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