盂唇缝合与清理治疗凸轮型股骨髋臼撞击症的疗效对比

Comparison of curative effect between labrum suture and debridement in the treatment of cam type femoral acetabular impingement

目的探讨髋关节镜下盂唇缝合与清理治疗凸轮型股骨髋臼撞击伴发盂唇损伤的效果比较。方法回顾性分析2017年1月~2018年10月中国医科大学附属盛京医院收治的诊断为凸轮型股骨髋臼撞击症的46例患者的临床资料,根据损伤盂唇的处理方式分为盂唇缝合组(23例)与盂唇清理组(23例)。比较两组术前及术后末次随访时屈髋90°髋关节内旋活动度、α角、改良Harris评分(mHHS)、VAS疼痛评分(VAS);评价两组患者术后的临床疗效。结果所有患者均获随访。两组末次随访时改良Harris评分与屈髋90°髋关节内旋活动度均高于术前,差异有统计学意义(P<0.05)。两组末次随访时VAS疼痛评分与α角均低于术前,差异有统计学意义(P<0.05)。两组术后末次随访时屈髋90°髋关节内旋活动度、改良Harris评分及VAS疼痛评分比较差异均有统计学意义(均P<0.05)。结论髋关节镜下盂唇清理与缝合治疗凸轮型FAI均能明显缓解髋部疼痛,改善髋关节活动度,且盂唇缝合比盂唇清理术后疗效更好。

Objective To compare the clinical effect of arthroscopic labral repair and labral debridement in the treatment of cam-type femoroacetabular impingement(FAI)with labrum tear.Methods The clinical data of 46 patients diagnosed as cam-tye FAI in Shengjing Hospital of China Medical University from January 2017 to October 2018 were analyzed.They were divided into labral repair group(23)and labral debridement group(23)according to the different treatment methods of the labral.The preoperative and postoperative range of internal rotation when hip flexion was 90 degrees,αangle,visual analogue scale(VAS)and the modified Harris hip function score(mHHS)were compared between the two groups to evaluate the clinical efficacy.Results All patients were followed up.At the last follow-up,the postoperative range of internal rotation when hip flexion was 90 degrees and the modified Harris hip function score of the 2 groups were higher significantly compared with those before surgery(P<0.05),the postoperative visual analogue scale andαangle were lower significantly compared with those before surgery(P<0.05).At the last follow-up,there were statistically significant differences between the two groups in the range of internal rotation when hip flexion was 90 degrees,visual analogue scale and the modified Harris hip function score(P<0.05).Conclusion Arthroscopic pelvic lip debridement and suture in the treatment of cam Fai can significantly relieve hip pain and improve the range of motion of hip joint,and the curative effect of pelvic lip suture is better than that of pelvic lip debridement.