METHODS: Data were retrospectively collected from patients with global pincer FAI who underwent hip arthroscopy with a minimum follow-up period of 2 years from May 2014 to December 2018. Patients with global pincer FAI were subdivided into low or high resection depth groups based on whether the intraoperative acetabular rim was resected by more than 3 mm. Radiographic measurements; arthroscopic procedures; preoperative and postoperative PROs were recorded. Achievement of MCID and PASS was compared for the VAS, mHHS, HOS-ADL, and iHOT-12. A paired Student t-test was used to evaluate the significance of preoperative and postoperative PROs and two-tailed unpaired Student t-test was used to compare demographic data and PROs between different groups. MCID and PASS were evaluated using the chi-square test or the Fisher\'s exact test.
RESULTS: A total of 41 hips with global pincer FAI (15 and 26 patients in low or high resection depth groups, respectively) were included in this study. Both groups showed significant postoperative improvements in the scores of all PROs (p < 0.001). Compared to the low resection depth group, the high resection depth group had a lower degree of improvement through hip arthroscopy, which manifested as lower postoperative mHHS scores (94.29 vs. 85.08, p = 0.006), higher VAS scores (0.93 vs. 2.54, p = 0.002), and lower improvements in VAS (-5.00 vs. -3.35, p = 0.028), HOS-ADL (34.99 vs. 23.90, p = 0.017) and iHOT-12 (39.89 vs. 29.27, p = 0.036). Patients in high resection depth group were less likely to achieve the MCID for the VAS score compared to low resection depth group in significant (73.3 vs. 26.9%, p = 0.004).
CONCLUSIONS: For patients with global pincer, the outcomes in high resection depth group were slightly worse than the the low resection depth group. It is indicated that excessive resection of the acetabular rim during the procedure should be avoided.
方法:回顾性收集了2014年5月至2018年12月接受髋关节镜检查的全球钳FAI患者的数据,随访时间最少为2年。根据术中髋臼缘切除是否超过3mm,将具有整体钳FAI的患者细分为低或高切除深度组。射线照相测量;关节镜程序;记录术前和术后PRO。对VAS的MCID和PASS的成就进行了比较,mHHS,HOS-ADL,iHOT-12使用配对的Studentt检验来评估术前和术后PRO的显著性,并且使用双尾未配对的Studentt检验来比较不同组之间的人口统计学数据和PRO。使用卡方检验或Fisher精确检验评估MCID和PASS。
结果:共有41个髋部具有整体钳FAI(低或高切除深度组的15和26名患者,分别)纳入本研究。两组术后所有PRO评分均有显著改善(p<0.001)。与低切除深度组相比,高切除深度组通过髋关节镜检查的改善程度较低,表现为术后mHHS评分较低(94.29vs.85.08,p=0.006),更高的VAS分数(0.93vs.2.54,p=0.002),和较低的VAS改进(-5.00vs.-3.35,p=0.028),居屋计划(34.99vs.23.90,p=0.017)和iHOT-12(39.89vs.29.27,p=0.036)。与低切除深度组相比,高切除深度组患者获得VAS评分的MCID的可能性较小(73.3vs.26.9%,p=0.004)。
结论:对于全局钳的患者,高切除深度组的结局略差于低切除深度组.表明应避免在手术过程中过度切除髋臼边缘。