髋关节镜治疗股骨髋臼撞击综合征中短期疗效观察

Short-medium outcomes of the head-acetabularplasty efficacy in the treatment of femoroacetabular impingement (FAI) with hip arthroscopy

目的探讨髋关节镜下行头臼成形术治疗股骨髋臼撞击综合征临床疗效。方法回顾分析2012年1月至2016年12月收治的30例（30髋）股骨髋臼撞击综合征患者,其中男19例,女11例,左髋21例,右髋9例,年龄22-50岁,平均年龄34.91岁。根据分型分别于关节镜下行股骨头成型术、髋臼成型术以及髋臼成型联合股骨头成型术,患者术后均采用Harris评分评估临床疗效并随访研究。结果所有患者均获随访,平均随访时间43.2月（34-51月）,术前Harris髋关节评分为（65.7±6.3）分,术后3、6、12个月及末次随访分别为（74.5±6.0）、（79.2±6.1）、（82.5±6.1）、和（83.1±8.2）分,与术前比较差异有显著性（P〈0.05）,术后1年内Harris评分持续改善差异有显著性（P〈0.05）。结论髋关节镜治疗股骨髋臼撞击综合征可有效消除或减轻髋部疼痛、改善关节活动功能,可成为治疗股骨髋臼撞击综合征的良好选择。

Objective To investigate the head-acetabularplasty efficacy in the treatment of femoroacetabular impingement（FAI） with hip arthroscopy. Methods A total of 30 patients（30 hips） who were diagnosed as FAI between January 2012 and December 2016 FAI were retrospectively reviewed, which consisted of 19 men and 11 women at an average of 34.91 years old（ranging from 22 years old to 50 years old）. According the types of impingement, there were three types among them, which include 18 cases of Cam, 6 cases of Pincer and 6 cases of both. Clinical outcomes were assessed through the Harris Hip Score（HHS） of per-and post-operation and postoperative follow-ups were also performed. Results All patients were followed up completely, the mean follow-up time in the arthroscopy group were 43.2 months（ranging from 34 months to 51 months）. The preoperative HHS was（65.7 ± 6.3）, which was improved to（74.5 ± 6.0）,（79.2±6.1）,（82.5±6.1） and（83.1±8.2） 3 months, 6 months, 12 months after the surgery and final follow-up,respectively. All the postoperative improvements were of statistical significance（P 0.05）. No major complications occurred during perioperative period and follow-up, and no cases converted to total hip arthroplasty. Conclusions The hip arthroscopy procedure shows advantages of minimal invasion with certain efficacy of relieving pain, improving hip function and modified OA progression aimed to delay THA surgeries. Thus, we recommend that mini-invasive hip arthroscopy surgery might be an optimal procedure in treating FAI.