关节镜清理术治疗青少年强直性脊柱炎早期髋关节病变的疗效

Effect of arthroscopic debridement for adolescent ankylosing spondylitis with early hip-joint disease

目的探讨关节镜清理术治疗青少年强直性脊柱炎早期髋关节病变的疗效。方法本组为自2001至2008年22例（26髋），男15例，女7例。平均年龄16岁（14～19岁）。左侧10例，右侧8例，双髋4例。麻醉下推拿活动解除髋关节粘连，关节镜下清理增生肥厚的滑膜和剥脱的软骨碎屑，术后进行髋关节功能康复训练。结果术后随访22例，平均26个月（6个月至7年）。疗效评价采用Harrss髋关节功能评分和VAS疼痛评分，优6例，良14例，差2例。本组无人工关节置换病例。结论髋关节镜清理术治疗青少年强直性脊柱炎早期髋关节病变，有利于减轻髋关节症状，增加髋关节活动度。

Objective To study the effect of arthroscopy debridement for adolescent ankylosing spondylitis （AS） with early hip-joint disease. Methods A total of 22 cases （26 hips） of adolescent AS were recruited. There were 15 males and 7 females. The distribution was as follows： left side （n = 10） , right side （n---8 ） and bilateral （n = 4 ）. The average age was 16 （14-19） years old. The procedures included adhesion relief of hip joint, removal of hyperplasic synovial membrane, degenerated cartilage debris and repairing exfoliated debris or exposed subchondral bone on hip joint. Results All patients were followed up for an average of 26 （6-84） months. Most patients experienced pain relief, restored function and the range of motion. According to Harris hip joint score and VAS pain score evaluation system, the outcomes were excellent （n = 6） fair （n = 14） and poor （n = 2） . There was no case of total hip replacement. Conclusion Arthroscopic debridement for adolescent ankylosing spondylitis with early hip joint disease is effective to improve joint motion and relieve pain.