髋关节镜手术治疗髋臼盂唇损伤合并囊肿的临床疗效

Clinical efficacy of hip arthroscopy in the treatment of acetabular labral injury with cysts

目的探讨髋关节镜手术治疗髋臼盂唇损伤合并囊肿的临床疗效。方法回顾性分析2017年1月至2022年4月于天津市天津医院运动损伤与关节镜科接受髋关节镜手术治疗髋臼盂唇损伤合并囊肿的患者14例,男5例、女9例,年龄(35.46±12.62)岁(范围26~57岁)。左髋8例、右髋6例,体质指数(24.35±3.14)kg/m^(2)(范围20.2~28.4 kg/m^(2))。症状持续时间(6.25±4.39)个月(范围3~11个月)。所有患者行髋关节镜下囊肿清理、盂唇缝合术。比较患者手术前后的股骨颈α角、外侧中心边缘角、视觉模拟评分(visual analogue score,VAS)、Harris髋关节评分(Harris hip score,HHS)和国际髋关节结果工具(international hip outcome tool,iHOT-12)评分。结果所有患者均顺利完成手术并获得随访,随访时间为(10.23±2.45)个月(范围1.5~18个月)。患者手术前后髋关节VAS的差异有统计学意义(F=108.47,P<0.001)。术后18个月的VAS为(1.34±0.83)分,小于术前和术后6周的(7.85±1.12)分和(5.03±1.60)分,差异有统计学意义(P<0.05)。患者手术前后髋关节HHS评分的差异有统计学意义(F=96.89,P<0.001)。术后18个月的HHS评分为(85.58±4.65)分,大于术前和术后6周的(54.36±2.31)分和(61.12±1.20)分,差异有统计学意义(P<0.05)。患者手术前后iHOT-12评分的差异有统计学意义(F=117.92,P<0.001)。术后18个月的iHOT-12评分为(78.36±2.28)分,大于术前和术后6周的(31.39±5.21)分和(47.88±2.20)分,差异有统计学意义(P<0.05)。患者手术前后股骨颈α角的差异有统计学意义(F=101.56,P<0.001)。术后12个月的股骨颈α角为45.32°±3.16°,小于术前的50.86°±8.41°,差异有统计学意义(P<0.05)。患者手术前后外侧中心边缘角的差异有统计学意义(F=100.38,P<0.001)。术后12个月的外侧中心边缘角为28.23°±5.32°,小于术前的32.16°±5.13°,差异有统计学意义(P<0.001)。结论髋关节镜手术治疗髋臼盂唇损伤合并囊肿可改善髋部疼痛和提高髋关节功能。

ObjectiveTo investigate the clinical efficacy of hip arthroscopy in the treatment of acetabular labral injury combined with cysts.MethodsA total of 14 patients(5 males and 9 females)aged 35.46±12.62 years(range,26-57 years)with acetabular labral injury complicated with cyst who underwent hip arthroscopy in Department of Sports Injury and Arthroscopy,Tianjin Hospital from January 2017 to April 2022 were retrospectively analyzed.There were 8 cases of left hip and 6 cases of right hip with an average body mass index of 24.35±3.14 kg/m^(2)(range,20.2-28.4 kg/m^(2)).The duration of symptoms was 6.25±4.39 months(range,3-11 months).All patients underwent hip arthroscopic cyst cleaning and glenoid labral suturing.The femoral neckαangle,lateral center rim angle,visual analogue score(VAS),Harris hip score(HHS),and international hip outcome tool scores(iHOT-12)were compared before and after operation.ResultsAll patients successfully completed the operation and were followed up for 10.23±2.45 months(range,1.5-18 months).The difference between the patients'hip VAS before and after operation was statistically significant(F=108.47,P<0.001).The VAS score at 18 months after operation was 1.34±0.83,which was significantly lower than that before operation 7.85±1.12 and at 6 weeks after operation 5.03±1.60(P<0.05).The difference between the patients'hip HHS scores before and after operation was statistically significant(F=96.89,P<0.001).The HHS score at 18 months after operation was 85.58±4.65,which was significantly higher than that before operation 54.36±2.31 and 6 weeks after operation 61.12±1.20(P<0.05).The differences of iHOT-12 scores before and after operation were statistically significant(F=117.92,P<0.001).The iHOT-12 score of 18 months after operation was 78.36±2.28 points,which was higher than that before operation 31.39±5.21 points and 6 weeks after operation 47.88±2.20 points,and the difference was statistically significant(P<0.05).The difference ofαangle of femoral neck before and after operation was statistically significant(F=101.56,P<0.001).Theαangle of femoral neck at 12 months after operation was 45.32°±3.16°,which was significantly lower than that before operation 50.86°±8.41°(P<0.05).The difference of lateral center rim angle before and after operation was statistically significant(F=100.38,P<0.001).The lateral center rim angle was 28.23°±5.32°at 12 months after operation,which was smaller than that before operation 32.16°±5.13°,and the difference was statistically significant(P<0.05).ConclusionHip arthroscopy in the treatment of acetabular labral injury with cysts can relieve hip pain and improve hip function.