关节囊缝合与否对髋关节镜下手术治疗股骨髋臼撞击征临床效果的影响

Comparation of the efficacy of repaired and unrepaired capsule in treatment of femoroacetabular impingement with arthroscopy

目的 探讨髋关节镜下手术治疗股骨髋臼撞击征(FAI).缝合关节囊与否对治疗效果的影响.方法 采用前瞻性随机对照研究方法.将2017年2月至2017年10月北京积水潭医院行髋关节镜下手术治疗的60例FAI患者随机分为关节囊缝合组(简称缝合组)和关节囊不缝合组(简称未缝合组).每组30例.髋关节镜下依次行髋臼骨赘清理、髋臼损伤盂唇修补、股骨头颈结合区骨赘清除.术后随访12个月.测量并比较患者术前与术后的髋关节α角、LCE角.评估并比较患者术前和术后12个月的mHHS评分、VAS评分和髋关节活动度.并对患者满意度、并发症、手术时间等指标进行观察与比较.结果 缝合组手术时间长于未缝合组(P<0.05).两组术后α角和LCE角差异均无统计学意义(P>0.05).两组术后12个月患者满意率均为100%.均未见明显并发症.髋关节屈、伸、90°内旋和外旋活动度差异均无统计学意义(P>0.05).满意度评分、mHHs评分和VAS评分差异均无统计学意义(P>0.05).结论 髋关节镜下手术治疗FAI缝合关节囊与否均可获得相同的临床疗效.

Objective To compare the effects of arthroscopy in treatment of femoroacetabular impingement(FAI) with and without repair of the joint capsule. Methods In a RTC.60 patients with FAI treated by arthroscopy in Beijing Jishuitan Hospital between February and October 2017 were randomly assigned into 2 groups. unrepair capsulotomy(unrepaired group.n = 30) and capsular repair(repaired group.n = 30). All patients underwent arthroscopic hip surgery:the damaged labrum was repaired. and the femoroacetabular hyperplasia and osteophyte on head-neck were removed. The changes of the alpha angle when at Dunn position and lateral centre edge(LCE)angle at normotopia on the X-ray. the surgical satisfaction and complications were measured and recorded. The modified Harris hip score(mHHS). visual analogue scale(VAS). range of motion (ROM) and operative time were used to evaluate the hip function and pain relief of patients at 12 months after operation. Results The operative time in repaired group was longer than repaired group(P < 0. 05). No significant difference was found regarding alpha angle. LCE angle between the two groups. The patient satisfaction rate were both 100% and no serious complications occurred in the 2 groups. There was no significant difference in the satisfaction scores. mHHS score. VAS score and ROM(P > 0. 05)between the 2 groups. Conclusion The same effects could be obtained by repairing and not repairing the capsule in arthroscopic surgery on FAI.