摘要
目的 探讨髋关节镜下手术治疗股骨髋臼撞击征(FAI)缝合关节囊与否对患者术后髋关节功能的影响。方法 对2019年1月至12月北京积水潭医院运动医学科行髋关节镜下手术治疗的FAI患者62例临床资料进行回顾性分析。根据术中关节囊处理方式将患者分为缝合关节囊组(简称缝合组)和不缝合关节囊组(简称未缝合组)。缝合组包括患者38例,其中男11例,女27例,年龄(38.11±4.22)岁,FAI类型包括凸轮型10例、钳夹型6例和混合型22例;未缝合组包括患者24例,其中男11例,女13例,年龄(36.58±5.36)岁,FAI类型包括凸轮型6例、钳夹型4例和混合型14例。对未缝合组患者常规行髋臼骨赘清理、髋臼损伤盂唇修补和股骨头颈结合区骨赘清除,对缝合组患者在此基础上行关节囊缝合术。测量患者术前与术后的髋关节α角和外侧中心边缘(LCE)角并进行比较;对患者术前与术后髋关节内旋-外旋活动度(ROM)、Harris髋关节评分(HHS)、非关节炎髋评分(NAHS)和髋关节日常活动结果评分(HOS-ADL)进行评估和比较。结果 术后随访12个月。两组患者术后髋关节α角和LCE角均较术前有显著改善(均P<0.001),组间均无显著差异(均P>0.05)。术后1个月缝合组髋内旋-外旋ROM显著小于未缝合组(P<0.001);术后6个月和12个月,两组髋内旋-外旋ROM均较术前有显著改善(P<0.001),组间均无显著差异(均P>0.05)。缝合组术后HHS、NAHS和HOS-ADL评分均显著高于未缝合组(均P<0.001)。结论 关节镜手术治疗股骨髋臼撞击征术中常规行关节囊修补有利于获得更好的近期临床疗效,中长期效果仍需进一步观察。
Objective To investigate influence of joint capsule suturing after hip arthroscopic treatment of femoroacetabular impingement(FAI)on postoperative hip function.Methods A retrospective analysis was performed on 62 FAI patients who underwent standard hip arthroscopic surgery in the Department of Sports Medicine,Beijing Jishuitan Hospital from January to December 2019.According to the treatment of the capsule,the patients were divided into sutured joint capsule group(sutured group)and unsutured joint capsule group(unsutured group).The sutured group consisted 38 patients including 11 males and 27 females,aged(38.11±4.22)years,with 10 cam,6 pincer and 22 combined FAI.The unsutured group consisted 24 patients including 11 males and 13 females,aged(36.58±5.36)years,with 6 cam,4 pincer and 14 combined FAI.Routine acetabular osteophyte removal,injured acetabular labrum repair and femoral head and neck osteophyte removal were performed in the 2 groups,and joint capsule suture was performed in the sutured group.Theαangle and lateral center-edge(LCE)angle of the hip joint were measured and compared before and after surgery and between the 2 groups.The range of motion(ROM),Harris Hip Scale(HHS),non-arthritic hip score(NAHS)and Hip Outcome Score-Activities of Daily Living(HOS-ADL)were evaluated and compared before and after surgery and between the 2 groups.Results All patients were followed-up for more than 12 months.There were no statistically significant difference in internal and external rotatory ROM,HHS,NAHS and HOS-ADL between the 2 groups before surgery(all P>0.05).One month after surgery,the internal rotation ROM of the sutured group was significantly lower than that of the unsutured group(P<0.05).At 6 and 12 months postoperatively,there was no significant difference between the 2 groups in terms of internal rotation and external rotation ROM,which was significantly improved after surgery.The HHS,NAHS and HOS-ADL scores of the sutured group were significantly higher than those of the unsutured group at one,6 and 12
作者
曹旭
宋关阳
王雪松
Cao Xu;Song Guanyang;Wang Xuesong(Department of Sports Medicine, Beijing Jishuitan Hospital, Beijing 100035, China)
出处
《骨科临床与研究杂志》
2022年第4期203-209,共7页
Journal Of Clinical Orthopedics And Research
基金
吴阶平医学基金会临床科研专项(320.6750.2020-06-90)。
关键词
股骨髋臼撞击征
关节镜检查
关节囊
疗效比较研究
Femoracetabular impingement
Arthroscopy
Joint capsule
Comparative effectiveness research
