髋关节镜术治疗中青年髋关节盂唇钙化

Hip arthroscopy for treatment of labral amorphous calcification in young and middle-aged adults

[目的]评估关节镜技术治疗髋关节盂唇钙化的临床结果.[方法]2015年1月—2018年10月,15例行影像发现盂唇钙化患者纳入本研究,均行髋关节镜术治疗.评估患者临床与影像资料.[结果]术中镜下检查见盂唇钙化病灶位于髋臼前或上方11-3点位置.病变体积与术前VAS评分呈显著正相关(P<0.05),与术前mHHS和iHOT-12评分呈显著负相关(P<0.05).15例患者中,5例伴钳夹型,2例伴凸轮型,5例伴混合型FAI,单纯盂唇钙化仅3例.与术前相比,术后12个月和24个月VAS评分显著下降(P<0.05),而mHHS和iHOT-12评分均显著增加(P<0.05).影像方面,与术前相比,术后α角和LCEA均显著减少(P<0.05),而FHNO显著增加(P<0.05);15例患者影像检查均未见盂唇钙化复发,髋关节无明显退变.[结论]髋关节镜手术是治疗髋关节盂唇钙化的有效手段.钙化大小是术前症状及功能的影响因素之一.

[Objective]To evaluate the clinical outcome of hip arthroscopy for labral amorphous calcification.[Methods]From January 2013 to October 2017,15 patients who was diagnosed of labral amorphous calcification on images were enrolled in this study,and all received hip arthroscopy.The clinical and imaging data of the patients were evaluated.[Results]Intraoperatively,arthroscopic examination showed that the calcified lesion of labrum was located at 11-3 clock points in front or above the acetabulum.The lesion volume was significantly positively related to the preoperative VAS score(P<0.05),whereas significantly negatively related to the preoperative mHHS and iHOT-12 scores(P<0.05).Among the 15 patients,5 case were associated with pincer-type impingement,2 with cam-type FAI,5 with mixed FAI,and only 3 were simple labral calcification.The VAS scores significantly decreased(P<0.05),while the mHHS and iHOT-12 scores significantly increased at 12 and 24 months postoperatively compared with those before surgery(P<0.05).Radiographically,the a angle and lateral center edge angle(LCEA)significantly reduced(P<0.05),while the femoral head neck offset(FHNO)significantly increased after surgery compared with those preoperatively(P<0.05).No recurrence of labral calcification,and no obvious hip degeneration were seen in anyone of the 15 patients.[Conclusion]Hip arthroscopy is an effective method for the treatment of labral amorphous calcification.The size of calcification lesion might be one of the influencing factors of preoperative symptoms and function.