关节镜下射频松解治疗臀肌挛缩的临床疗效

Curative effect of minimally invasive treatment of gluteal muscle contracture under arthroscope

目的探讨关节镜下射频松解治疗臀肌挛缩的临床疗效。方法选取我院2015年6月~2018年12月收治的12例关节镜下松解臀肌挛缩症患者为研究对象,参照刘玉杰臀肌挛缩分型:条索型6例,扇型3例,混合型2例和阔筋膜张肌挛缩型1例;均在关节镜下射频松解挛缩带,直至屈曲、内收、内旋髋关节弹响消失。通过比较术前与末次随访臀肌挛缩功能量化评分、髋关节运动评分(HOS-sport)及髋关节日常生活评分(HOS-ADL)评估疗效。结果术后有2例出现局部血肿,经局部加压包扎后2~3 d血肿吸收;无切口感染以及坐骨神经损伤;平均随访(17±4.97)个月;末次随访臀肌挛缩功能量化评分、HOS-sport评分、HOS-ADL评分均较术前明显提高。结论关节镜下射频松解治疗臀肌挛缩,具有创伤小、操作安全、疗效可靠的优势,是一种有效的治疗方式。

Objective To investigate the clinical effect of radiofrequency for gluteal muscle contracture under arthroscope.Methods 12 patients with gluteal muscle contracture treated by arthroscopy in our hospital from June 2015 to December 2018 were selected as the research objects.According to Liu Yujie's classification of gluteal muscle contracture,there were 6 cases of strip type,3 cases of fan type,2 cases of mixed type and 1 case of tensor fascia lata contracture.The contracture band was released by radiofrequency under arthroscopy until flexion,adduction and internal rotation disappeared.The curative effect was evaluated by comparing the quantitative score of gluteal muscle contracture function,the hip movement score(HOS-sport)and the hip daily life score(HOS-ADL)before and after operation.Results Local hematoma occurred in 2 cases after operation,and was absorbed 2-3 days after local pressure bandage;There was no incision infection and sciatic nerve injury;The average follow-up time was(17±97)months;At the last follow-up,the quantitative score of gluteal muscle contracture,HOS sport score and hos ADL score were significantly higher than those before operation.Conclusion Arthroscopic treatment of gluteal muscle contracture has the advantages of less trauma,safe operation and reliable curative effect.