髋关节镜下治疗股骨髋臼撞击综合征的疗效及其X线指标分析

Therapeutic effect of femoral acetabular impact syndrome under the hip arthroscopy and analysis of X-ray indicators

目的分析髋关节镜下治疗不同解剖形态股骨髋臼撞击综合征(FAI)患者的临床疗效与相关X线指标情况。方法选择2015年9月-2016年12月在该院接受关节镜下手术治疗的FAI患者24例,分析患者的临床指标、术后疼痛、膝关节功能与活动度及并发症情况。结果与治疗前比较,患者治疗7 d、1个月、3个月及6个月后的视觉模拟评分法(VAS)评分较治疗前均明显降低,而Harris评分均明显增加,同时患者的膝关节活动度均明显增强,差异有统计学意义(P<0.05)。凸轮型患者髋关节的α角明显高于钳夹型,而偏心距、髋臼深度、髋臼覆盖率及中心边缘角(CE)明显低于钳夹型,比较差异有统计学意义(P<0.05);凸轮型患者的α角明显高于健康人髋关节、而偏心距明显低于健康人髋关节,比较差异有统计学意义(P<0.05);钳夹型患者的髋臼深度、髋臼覆盖率及CE角高于健康人髋关节,比较差异有统计学意义(P<0.05);而3者的髋臼前倾角比较,差异无统计学意义(P>0.05)。24例髋关节镜下治疗患者的并发症发生率为20.83%。结论髋关节镜下治疗FAI可短期减轻患者疼痛,提高膝关节功能与活动度,效果良好,且不同髋关节解剖形态的X线片差异明显。

Objective To analyze the clinical efficacy and related X-ray findings of patients underwentarthroscopic treatment of femoral acetabular impingement （FAI） syndrome with different anatomicalfeatures. Methods Twenty-four patients with FAI underwent arthroscopic surgery from September 2015 toDecember 2016 were selected to analyze the clinical features, postoperative pain, knee joint function, activity andcomplications. Results Compared with those before treatment, the visual analogue scale （VAS） scores of patients at7 d, 1 month, 3 months and 6 months after treatment were significantly lower than those before treatment, while theHarris scores were significantly increased, at the same time patients’ knee activity was significantly increased, Thedifference was statistically significant （P 〈 0.05）. The α angle of the hip joint of the cam-type patient was significantlyhigher than that of the jaw-type, while the eccentricity, acetabular depth, acetabular coverage and centerline （CE）angle were significantly lower than the jaw-type, and the difference was statistically significant （P 〈 0.05）; The αangle of the cam-type patient was significantly higher than that of the healthy person’s hip joint, and the eccentricity was significantly lower than that of the healthy person＇s hip joint. The difference was statistically significant（P 〈 0.05）; the acetabular depth and hip of the clamp-type patient Radon coverage and CE angle were higherthan those of hip joints in healthy people, and the difference was statistically significant （P 〈 0.05）. There was nosignificant difference in acetabular anterior tilt between the three groups （P 〉 0.05）. The incidence of complicationsin 24 patients underwent arthroscopy was 20.83%. Conclusion Hip arthroscopic treatment of hip impingementsyndrome can shorten the patient＇s pain relief, improve knee function and activity, its effect is good, and different hipanatomical X-ray film was significantly different.