关节镜治疗髋关节周围钙化性肌腱炎

Arthroscopic treatment for the calcific tendinitis at soft tissues around hip

目的:探讨关节镜治疗髋关节周围钙化性肌腱炎的可行性以及临床疗效。方法:回顾分析2013年5月至2018年7月采用关节镜手术治疗髋关节周围钙化性肌腱炎16例患者的病例资料,男10例,女6例,年龄35~63(44.50±6.67)岁,左髋9例,右髋7例,病程1~8(3.18±1.97) d。术前、术后1 d及末次随访采用疼痛视觉模拟评分(visual analogue scale,VAS),改良髋关节Harris评分(Harris hip scores,HHS),髋关节非骨性关节炎评分(nonarthritic hip score,NAHS)以及影像学进行髋关节功能评估。结果:所有患者顺利完成关节镜下髋关节周围钙化灶清除术,手术时间0.5~1.2(0.75±0.21) h。患者术后切口均Ⅰ期愈合,无感染、血肿以及血管神经损伤等并发症。所有患者获得随访,时间6~12(9.6±2.3)个月。术前患者VAS评分(7.88±0.72)分,改良HHS评分(29.25±3.23)分,NAHS评分(27.42±3.08)分,术后第1天患者髋关节疼痛以及活动度均明显改善,VAS评分(2.19±0.66)分,改良HHS评分(82.56±5.64)分,NAHS评分(82.11±2.94)分,与术前比较差异均有统计学意义(P<0.05)。末次随访所有患者影像学检查显示钙化灶完全消失,未见髋关节钙化灶复发,仅1例患者诉髋关节稍有酸胀感,VAS评分(0.38±0.50)分,改良HHS评分(94.31±2.82)分,NAHS评分(94.84±2.85)分,与术前比较差异均有统计学意义(P<0.05)。结论:采用关节镜治疗髋关节周围钙化性肌腱炎创伤小,可快速缓解疼痛改善髋关节功能,疗效确切。

Objective:To explore the feasibility and clinical effects of arthroscopic treatment for the calcific tendinitis at soft tissues around hip.Methods:A total of 16 patients diagnosed as the calcific tendinitis at soft tissues around hip from May 2013 to July 2018 were retrospectively analyzed.All the 16 patients received arthroscopic procedures.There were 10 males and 6 females with an average age of 35 to 63(44.50±6.67)years old and 9 left hips,6 right hips were involved.The course of disease were 1 to 8(3.18±1.97)days.Clinical effects were evaluated with visual analogue scale(VAS),modified Harris hip scores(HHS),nonarthritic hip score(NAHS)and imaging examinations before operation,1 day after operation and the final follow-up.Results:All 16 patients successfully finished the arthroscopic procedures in 0.5 to 1.2(0.75±0.21)hours.Primary healing of incision were obtained without any complications of infection,wound hematocele and neurovascular injury.All 16 patients received an average postoperative follow-up of 6 to 12(9.6±2.3)months.Before operation,the VAS were 7.88±0.72,modified HHS were 29.25±3.23,NAHS were 27.42±3.08.The 1st day postoperative VAS were 2.19±0.66,modified HHS were 82.56±5.64,NAHS were 82.11±2.94,all the difference were statistically significant between before and 1 day after operation(P<0.05).At the final follow-up,the VAS were 0.38±0.50,modified HHS were 94.31±2.82,NAHS were 94.84±2.85,all the scores were improved significantly compared to that before operation(P<0.05).At final follow-up,there was no recurrence and the calcification disappeared in all patients,there was one patient feel sourness around the hip.Conclusion:Arthroscopic treatment for the calcific tendinitis at soft tissues around hip is effective.It has advantages of minimal invasive,rapid pain relief,rapid hip joint function recovery and definite clinical effects.