摘要
目的:探讨股骨髋臼撞击(femoro-acetabular impingement,FAI)综合征患者髋关节镜术后并发髋关节炎(hip osteoarthritis,HOA)的危险因素,减少和预防HOA的发生。方法:自2018年9月至2020年9月采用髋关节镜手术治疗106例FAI患者,男40例,女66例;年龄20~55(33.05±10.19)岁;运动伤51例,交通事故伤36例,钝物砸伤19例;病程5~19(12.02±3.69)d。术后随访18个月,根据是否发生HOA将患者分为HOA组23例和无HOA组83例。采用多元Logistic回归分析影响FAI患者髋关节镜术后并发HOA的危险因素。结果:经单因素分析,HOA组年龄50~70岁、女性、身体质量指数>30 kg·m^(-2)、体力劳动、凸轮型、术后并发感染、术后末次随访髋关节关节活动度(range of motion,ROM)及Tonnis分级1级及以上比例均高于无HOA组(P<0.05),相对骨骼肌指数(relative appendicular skeletal muscle index,RASM)低于无HOA组(P<0.05)。多元Logistic回归分析结果显示,凸轮型、身体质量指数>30 kg·m^(-2)、术后末次随访髋关节内旋ROM及Tonnis分级≥1级是FAI患者髋关节镜术后发生HOA的危险因素(P<0.05)。结论:FAI分型、身体质量指数、髋部ROM、Tonnis分级均与FAI患者髋关节镜术后并发HOA有关,对高危FAI患者应加强随访和干预,以减少HOA的发生。
Objective To investigate the risk factors of hip osteoarthritis(HOA)after hip arthroscopy in patients with femoro-acetabular impingement(FAI)syndrome,and to reduce and prevent HOA.Methods From September 2018 to September 2020,106 patients with FAI underwent hip arthroscopy,including 40 males and 66 females,aged from 20 to 55 years old with an average age of(33.05±10.19)years old.The mechanism of injury included 51 cases for sports injury,36 for traffic accidents,and 19 for blunt object injury.The duration of the disease ranged from 5 to 19 days with an average of(12.02±3.69)days.All patients were followed up for 18 months.Patients were divided into HOA group(23 cases)and non-HOA group(83 cases)according to the occurrence of HOA.Multivariate Logistic regression was used to analyze the risk factors of HOA after hip arthroscopy in FAI patients.Results By univariate analysis,aged from 50 to 70 years old,female,body mass index(BMI)>30 kg·m^(-2),physical labor,cam type,postoperative infection,last follow-up hip degree of motion(range of motion,ROM)(flexion,abduction,adduction,internal rotation)and Tonnis grade 1 and above of the HOA group were higher than those of the non-HOA group(P<0.05),and the relative appendicular skeletal muscle index(RASM)was lower than that of non-HOA group(P<0.05).By multiple Logistic regression analysis,cam type,BMI>30 kg·m^(-2),last follow-up hip internal rotation ROM and Tonnis grade 1 were risk factors for HOA after hip arthroscopy in FAI patients(P<0.05).Conclusion FAI classification,body mass index,hip ROM and Tonnis grade are all related to HOA after hip arthroscopy in FAI patients.Follow-up and intervention should be strengthened in high-risk FAI patients to reduce the occurrence of HOA.
作者
柯磊
寇文冠
马晨
张月震
刘东帅
KE Lei;KOU Wen-guan;MA Chen;ZHANG Yue-zhen;LIU Dong-shuai(Department of Pain,Minimally Invasive Spine,Cangzhou People's Hospital,Cangzhou061000,Hebei,China;The 3rd Department of Orthopaedics and Joints,Transport Medicine,Cangzhou People's Hospital,Cangzhou061000,Hebei,China;Department of Spine,Cangzhou People's Hospital,Cangzhou061000,Hebei,China)
出处
《中国骨伤》
CAS
CSCD
2024年第2期179-183,共5页
China Journal of Orthopaedics and Traumatology
基金
河北省医学科学研究课题计划项目(编号:20220320)。
关键词
股骨髋臼撞击综合征
髋关节镜
髋关节炎
凸轮型
肥胖
Tonnis分级
Femoral acetabular impingement syndrome
Hip arthroscopy
Hip osteoarthritis
Cam type
Obesity
Tonnis classification
