Gao Guanying, Liu Rongge, Zhu Yichuan, Liu Jiayang, Wang Jianquan, Xu Yan
Department of Sports Medicine, Institute of Sports Medicine, Beijing Key Laboratory of Sports Injuries, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
J Orthop Surg Res. 2025 Sep 24;20(1):828. doi: 10.1186/s13018-025-06243-8.
To determine the prevalence of the femoral head infarction (FHI) following hip arthroscopy, explore potential contributing factors, and assess its influence on clinical outcomes.
We evaluated consecutive patients who underwent hip arthroscopy in our hospital between May 2014 and May 2023 retrospectively. Patients underwent MRI at least one year after surgery. FHI was identified as large scale edema signal at the junction of the femoral head and neck in postoperative MRI. FHI were matched in a 1:3 cohort to the normal group based on sex, age, and body mass index (BMI). Preoperative patient-reported outcomes (PROs) and PROs at least one year after surgery were obtained.
A total of 372 patients were finally included in this study. In the MRI follow-up, it was discovered that ten patients (2.7%) had FHI. Patients in FHI group had significantly lower BMI than patients without FHI (P = 0.008). Patients in the FHI group did not show significant improvements in postoperative mHHS, iHOT-12, or VAS scores (P > 0.05). Patients in the FHI group demonstrated significantly lower postoperative mHHS and iHOT-12 scores, along with higher VAS scores (P < 0.05). In the FHI group, only 3 patients (30%) surpassed the MCID and achieved the PASS for mHHS, while no patients surpassed the MCID or achieved the PASS for iHOT-12. The proportion of patients who achieved the MCID or the PASS in the normal group was significantly higher than that in the FHI group (P < 0.05).
Our study demonstrated that FHI could be a rare complication following hip arthroscopy. Patients with lower BMI are at a higher risk of developing postoperative FHI. The clinical outcomes for patients with FHI are poor, with no significant improvement in patient-reported outcomes observed.
确定髋关节镜检查后股骨头梗死（FHI）的发生率，探索潜在的影响因素，并评估其对临床结果的影响。
我们回顾性评估了2014年5月至2023年5月期间在我院接受髋关节镜检查的连续患者。患者在术后至少一年接受磁共振成像（MRI）检查。FHI被定义为术后MRI中股骨头与颈部交界处的大范围水肿信号。根据性别、年龄和体重指数（BMI），将FHI患者按1:3的队列与正常组进行匹配。获取术前患者报告结局（PROs）和术后至少一年的PROs。
本研究最终纳入372例患者。在MRI随访中，发现10例患者（2.7%）发生FHI。FHI组患者的BMI显著低于无FHI患者（P = 0.008）。FHI组患者术后改良Harris髋关节评分（mHHS）、国际髋关节结果评分-12（iHOT-12）或视觉模拟评分（VAS）无显著改善（P > 0.05）。FHI组患者术后mHHS和iHOT-12评分显著较低，VAS评分较高（P < 0.05）。在FHI组中，只有3例患者（30%）超过最小临床重要差异（MCID）并达到mHHS的通过标准，而没有患者超过MCID或达到iHOT-12的通过标准。正常组达到MCID或通过标准的患者比例显著高于FHI组（P < 0.05）。
我们的研究表明，FHI可能是髋关节镜检查后一种罕见的并发症。BMI较低的患者术后发生FHI的风险较高。FHI患者的临床结果较差，患者报告结局无显著改善。
