Abstract：
OBJECTIVE: Global pincer is a relatively rare form of pincer deformity and is typically associated with technical challenges during surgery. So far, controversy remains whether patients with global pincer have equivalent surgical outcomes compared to patients with focal pincer. This study compares the clinical outcomes of arthroscopic treatment between patients with global pincer femoroacetabular impingement (FAI) and focal pincer FAI in the Chinese population.
METHODS: Data were retrospectively collected from patients with global and focal pincer FAI who underwent hip arthroscopy with a minimum two-year follow-up between April 2016 and December 2018. Radiographic measurements, arthroscopic procedures, preoperative and postoperative patient-reported outcomes (PROs) including modified Harris hip score (mHHS), hip outcome score-activities of daily living (HOS-ADL), international hip outcome tool-12 (iHOT-12), and visual analogue scale (VAS) scores, rates of revision surgery and conversion to total hip arthroplasty (THA) were recorded. Achievement of minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) was compared for the VAS, mHHS, HOS-ADL, and iHOT-12 scores between groups.
RESULTS: The total of 33 and 167 patients were included in the global and focal group, respectively. There were no intergroup differences in age, gender, body mass index or follow-up times. Lateral center-edge angle (LCEA) was reduced in both groups postoperatively. Both groups demonstrated significant improvements in PROs compared with preoperative levels at the final follow-up. The preoperative scores showed significant differences in terms of mHHS (60.34 vs 62.90, P = 0.031) and HOS-ADL (61.45 vs 64.74, P = 0.022) scores between two groups, and the improvement of HOS-ADL score was significantly higher in global group (P = 0.027). However, the postoperative scores, including VAS, mHHS, HOS-ADL, and iHOT-12 scores, showed no significant differences between two groups. And there were no significant differences in the rate of meeting the PASS and MCID between groups. One (3.0%) in the global group and six (3.6%) patients in the focal group underwent revision arthroscopy respectively, with no significant difference (P = 0.876). There were no conversions to THA in both groups.
CONCLUSIONS: Arthroscopic management of global pincer FAI can achieve excellent functional scores at minimum 2-year follow-up. The outcomes were similar to focal pincer FAI patients with a low rate of secondary procedure.
METHODS: Data were retrospectively collected from patients with global and focal pincer FAI who underwent hip arthroscopy with a minimum two-year follow-up between April 2016 and December 2018. Radiographic measurements, arthroscopic procedures, preoperative and postoperative patient-reported outcomes (PROs) including modified Harris hip score (mHHS), hip outcome score-activities of daily living (HOS-ADL), international hip outcome tool-12 (iHOT-12), and visual analogue scale (VAS) scores, rates of revision surgery and conversion to total hip arthroplasty (THA) were recorded. Achievement of minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) was compared for the VAS, mHHS, HOS-ADL, and iHOT-12 scores between groups.
RESULTS: The total of 33 and 167 patients were included in the global and focal group, respectively. There were no intergroup differences in age, gender, body mass index or follow-up times. Lateral center-edge angle (LCEA) was reduced in both groups postoperatively. Both groups demonstrated significant improvements in PROs compared with preoperative levels at the final follow-up. The preoperative scores showed significant differences in terms of mHHS (60.34 vs 62.90, P = 0.031) and HOS-ADL (61.45 vs 64.74, P = 0.022) scores between two groups, and the improvement of HOS-ADL score was significantly higher in global group (P = 0.027). However, the postoperative scores, including VAS, mHHS, HOS-ADL, and iHOT-12 scores, showed no significant differences between two groups. And there were no significant differences in the rate of meeting the PASS and MCID between groups. One (3.0%) in the global group and six (3.6%) patients in the focal group underwent revision arthroscopy respectively, with no significant difference (P = 0.876). There were no conversions to THA in both groups.
CONCLUSIONS: Arthroscopic management of global pincer FAI can achieve excellent functional scores at minimum 2-year follow-up. The outcomes were similar to focal pincer FAI patients with a low rate of secondary procedure.
摘要：
目的：全球钳是一种相对罕见的钳畸形形式，通常与手术过程中的技术挑战有关。到目前为止,与具有局灶性钳的患者相比,具有整体钳的患者是否具有相同的手术结局仍存在争议.这项研究比较了中国人群中整体夹钳股骨髋臼撞击（FAI）和局灶性夹钳FAI患者的关节镜治疗的临床结果。
方法：回顾性收集了2016年4月至2018年12月期间接受髋关节镜检查并至少进行两年随访的全局和局灶性FAI患者的数据。射线照相测量,关节镜手术，术前和术后患者报告的结果（PRO），包括改良的Harris髋关节评分（mHHS），髋关节结局评分-日常生活活动(HOS-ADL)，国际髋关节结果工具-12(iHOT-12)，和视觉模拟量表(VAS)评分，记录翻修手术和全髋关节置换术(THA)的转换率.VAS比较了最小临床重要差异（MCID）和患者可接受症状状态（PASS）的实现，mHHS,HOS-ADL,两组之间的iHOT-12评分。
结果：总共33和167名患者被纳入全局和病灶组，分别。在年龄上没有组间差异，性别,体重指数或随访时间。术后两组患者的外侧中心边缘角（LCEA）均降低。在最后一次随访中，与术前水平相比，两组的PRO均有显着改善。术前mHHS评分(60.34vs62.90,P=0.031)和HOS-ADL评分(61.45vs64.74,P=0.022)差异有统计学意义。整体组HOS-ADL评分改善明显高于对照组(P=0.027)。然而,术后评分,包括VAS,mHHS,HOS-ADL,iHOT-12得分,两组间无显著性差异。而各组间PASS和MCID的满足率无显著差异。全组1例(3.0%)患者和局灶组6例(3.6%)患者分别行关节镜翻修术,差异无统计学意义(P=0.876)。两组均无THA转换。
结论：关节镜治疗全球钳形FAI可以在至少2年的随访中获得优异的功能评分。结果与局部夹钳FAI患者相似，二次手术率较低。
方法：回顾性收集了2016年4月至2018年12月期间接受髋关节镜检查并至少进行两年随访的全局和局灶性FAI患者的数据。射线照相测量,关节镜手术，术前和术后患者报告的结果（PRO），包括改良的Harris髋关节评分（mHHS），髋关节结局评分-日常生活活动(HOS-ADL)，国际髋关节结果工具-12(iHOT-12)，和视觉模拟量表(VAS)评分，记录翻修手术和全髋关节置换术(THA)的转换率.VAS比较了最小临床重要差异（MCID）和患者可接受症状状态（PASS）的实现，mHHS,HOS-ADL,两组之间的iHOT-12评分。
结果：总共33和167名患者被纳入全局和病灶组，分别。在年龄上没有组间差异，性别,体重指数或随访时间。术后两组患者的外侧中心边缘角（LCEA）均降低。在最后一次随访中，与术前水平相比，两组的PRO均有显着改善。术前mHHS评分(60.34vs62.90,P=0.031)和HOS-ADL评分(61.45vs64.74,P=0.022)差异有统计学意义。整体组HOS-ADL评分改善明显高于对照组(P=0.027)。然而,术后评分,包括VAS,mHHS,HOS-ADL,iHOT-12得分,两组间无显著性差异。而各组间PASS和MCID的满足率无显著差异。全组1例(3.0%)患者和局灶组6例(3.6%)患者分别行关节镜翻修术,差异无统计学意义(P=0.876)。两组均无THA转换。
结论：关节镜治疗全球钳形FAI可以在至少2年的随访中获得优异的功能评分。结果与局部夹钳FAI患者相似，二次手术率较低。
