全程无透视关节镜技术在髋关节撞击征手术中的应用效果研究

Outcomes of fluoroscopy-free hip arthroscopy technique in the treatment of femoroacetabular impingement syndrome

目的 探索全程无透视技术在关节镜治疗髋关节撞击征(FAI)手术中的临床应用效果。 方法 回顾性队列研究。回顾性分析2018年10月至2021年12月在解放军总医院第四医学中心接受髋关节镜手术治疗的FAI患者的临床资料。按手术方式将患者分为无透视和透视两组。通过对比两组患者手术时间、术前及术后末次随访的改良Harris髋关节评分(mHHS)、国际髋关节结果工具评分(iHOT12)、疼痛视觉模拟评分(VAS)以及手术并发症发生率评价手术效果。 结果 共纳入有效随访的患者460例,其中男213例,女247例,年龄(32.6±8.3)岁(15~67岁),无透视组275例,透视组185例。无透视组手术时间[(93.36±12.54)min]较透视组的[(115.62±6.03)min]短,两组比较差异有统计学意义( P <0.001)。两组患者自身对照末次随访与术前相比VAS评分均下降,mHHS评分及iHOT12评分均提高,差异均有统计学意义(均 P <0.001);但两组组间评分差异均无统计学意义(均 P >0.05)。无透视组并发症发生率为10.18%(28/275),与透视组的10.81%(20/185)相比差异无统计学意义( P =0.829)。 结论 全程无透视髋关节镜手术治疗FAI可避免射线辐射,可显著缩短手术时间,不增加术中并发症发生率,临床效果确切。

Objective To evaluate the effect of fluoroscopy-free technique in the arthroscopic treatment of femoroacetabular impingement syndrome(FAIS).Methods A retrospective cohort study.Clinical data of FAI patients treated with hip arthroscopy in the No.4 Medical Center,PLA General Hospital from October 2018 to December 2021 were retrospectively analyzed.The patients were divided into two groups according to the surgical procedure:the fluoroscopy group and the fluoroscopy-free group.The operation time and modified Harris hip score(mHHS),international hip outcome tool(iHOT12)and visual analogue scale(VAS)of hip joint pain before and after the operation were observed and compared between the two groups.And the incidence of surgical complications in the two groups were compared too.Results A total of 460 patients(213 males and 247 females)[aged(32.6±8.3)years(15-67 years)]with valid follow-up were included in this study.There were 275 cases in the fluoroscopy-free group and 185 cases in the fluoroscopy group.The operation time was shorter in the fluoroscopy-free group when compared with that in the fluoroscopy group,and the difference was statistically significant[(93.36±12.54)min vs(115.62±6.03)min,P<0.001].In both groups,the VAS scores decreased and the mHHS scores and iHOT12 scores improved significantly at the last follow-up when compared with those before the operation(all P<0.001);however,there was no significant difference in the scores between the two groups(all P>0.05).The complication rate in the fluoroscopy-free group was 10.18%(28/275),and it was 10.81%(20/185)in the fluoroscopy group(P=0.829).Conclusion Fluoroscopy-free hip arthroscopy technique for FAI can avoid radiation and shorten the operation time,but it does not increase the incidence of complications with reliable clinical outcomes.