Jia Di, Ran Qiguo, Sun Fei, Zhang Kun, Li Yanlin
Department of Sports Medicine, First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China.
Department of Orthopedics, Luliang County Hospital of Traditional Chinese Medicine, Qujing Yunnan, 655600, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Jul 15;39(7):848-854. doi: 10.7507/1002-1892.202504110.
To compare the effectiveness of arthroscopic outside-in release for gluteal muscle contracture (GMC) in supine position versus lateral decubitus position.
The clinical data of 34 GMC patients meeting selection criteria between January 2022 and May 2023 were retrospectively analyzed. Arthroscopic contracture band release was performed in the lateral decubitus position (lateral group, =14) or the supine position (supine group, =20). No significant difference ( >0.05) was observed between groups in baseline data, including gender, age, body mass index, preoperative GMC functional quantitative score, modified Harris hip score (mHHS), visual analogue scale (VAS) pain score, and hip flexion/adduction range of motion (ROM). The total operation time, release procedure time, non-release procedure time, intraoperative blood loss, hospital stay, and postoperative complications were recorded and compared. Functional outcomes (GMC functional quantitative score, mHHS score, VAS score, hip flexion/adduction ROM) were evaluated preoperatively and at 3, 12, and 24 months postoperatively.
All incisions healed by first intention without major vascular or neurological complications. In the lateral group, 3 patients developed patchy bruising on bilateral buttocks and posterior thighs at 3 days after operation, which resolved after 2 weeks of ice packs and ultrasonic therapy. The supine group demonstrated significantly shorter total operation time, non-release procedure time, hospital stay, and reduced intraoperative blood loss versus the lateral group ( <0.05). No significant difference was found in release procedure time ( >0.05). All patients were followed up 24 months. Both groups showed significant improvements ( <0.05) in mHHS score, GMC functional quantitative score, VAS score, and hip adduction/flexion ROM at all postoperative timepoints compared to preoperative values, with no significant intergroup differences ( >0.05).
Both surgical positions effectively improve hip function in GMC patients. However, the supine position offers significant advantages over the lateral decubitus position in operation time, anesthesia management, intraoperative blood loss control, and reduced hospital stay.
比较仰卧位与侧卧位关节镜下由外向内松解术治疗臀肌挛缩（GMC）的效果。
回顾性分析2022年1月至2023年5月间34例符合入选标准的GMC患者的临床资料。在侧卧位（侧卧位组，n = 14）或仰卧位（仰卧位组，n = 20）下行关节镜下挛缩带松解术。两组患者的基线数据，包括性别、年龄、体重指数、术前GMC功能定量评分、改良Harris髋关节评分（mHHS）、视觉模拟量表（VAS）疼痛评分以及髋关节屈伸/内收活动范围（ROM），差异均无统计学意义（P>0.05）。记录并比较两组患者的总手术时间、松解操作时间、非松解操作时间、术中出血量、住院时间及术后并发症。术前及术后3个月、12个月和24个月评估功能结局（GMC功能定量评分、mHHS评分、VAS评分、髋关节屈伸/内收ROM）。
所有切口均一期愈合，未发生重大血管或神经并发症。侧卧位组3例患者术后3天双侧臀部及大腿后侧出现片状瘀斑，经2周冰敷及超声治疗后消退。与侧卧位组相比，仰卧位组患者的总手术时间、非松解操作时间、住院时间显著缩短，术中出血量减少（P<0.05）。松解操作时间差异无统计学意义（P>0.05）。所有患者均随访24个月。与术前相比，两组患者术后各时间点的mHHS评分、GMC功能定量评分、VAS评分及髋关节内收/屈伸ROM均有显著改善（P<0.05），组间差异无统计学意义（P>0.05）。
两种手术体位均能有效改善GMC患者的髋关节功能。然而，仰卧位在手术时间、麻醉管理、术中出血量控制及缩短住院时间方面比侧卧位具有显著优势。
