关节镜下盂唇重建治疗髋关节撞击综合征12例

Arthroscopic labrum reconstruction for femoroacetabular impingement syndrome:12 cases report

髋关节撞击综合征(femoroacetabular impingement,FAI),又名股骨髋臼撞击综合征,多见于喜好运动的青壮年,以髋关节疼痛和活动受限为特征,其发病机制为股骨近端和/或髋臼的解剖形态异常,造成髋关节在活动终末期发生撞击,长此以往引起盂唇和软骨损伤,继而进展为髋关节骨关节炎。

To investigate the surgical effect of hip arthroscopic labrum reconstruction.A retrospective study was performed on the clinical data of 12 patients who underwent hip arthroscopic labrum reconstruction in our department from September 2017 to February 2021 and were followed up for 5-46 months,with an average of 21.5 months.All the patients had a hip joint space of more than 2 mm,and Tonnis grade less than level Ⅱ.These 12 patients underwent arthroscopic debridement of hyperplastic synovium,femoral head and neck and/or acetabular osteoplasty,and labrum reconstruction using autograft iliotibial band or gracilis tendon.After the surgery,we conducted follow-up and data collection,recorded the satisfaction of the patients and occurrence of complications,as well as the cartilage lesion of hip joint observed under the arthroscopy.We compared the alpha angle of Dunn X-ray film,center-edge angle(CE angle) of AP X-ray film,modified Harris hip score(m HHS score),hip outcome score(HOS),international hip outcome tool 12 score(iHOT12 Score),and visual analogue scale(VAS scale) before and after the arthroscopic operation,to assess clinical symptom relief and joint function recovery.The 12 patients were followed up for 5-46(21.5 ± 12.8) months.The VAS scale were(5.3 ± 2.5) and(2.5 ±1.4) before and after the surgery,showing significant decrease(P = 0.018).The mHHS score were(60.6 ± 22.2) and(83.1 ± 5.8) before and after the surgery,showing significant increase(P =0.003).The patient satisfaction was high(7.8 ± 2.0)(range:0-10).None of the 12 patients had serious complications,revision surgery,or total hip replacement at the end of the last follow-up.Autologous tendon transplantation for reconstruction of acetabular labrum under arthroscopy can improve the clinical symptoms and joint function of patients with femoroacetabular impingement(FAI),which is a safe and effective treatment.