PDF(Pubmed)
Abstract：
UNASSIGNED: Previous biomechanical studies have identified capsular closure, labral repair or reconstruction, and osteochondroplasty as important surgical interventions to improve hip stability.
UNASSIGNED: To investigate the outcome metrics used to quantify hip stability and assess and measure the relative contributions of the labrum, capsule, and bone to hip stability through a quantitative analysis.
UNASSIGNED: Systematic review and meta-analysis; Level of evidence, 4.
UNASSIGNED: PubMed and Embase databases were searched using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included studies evaluated cadaveric hip biomechanics related to capsular, labral, and bony management during hip arthroscopy. Studies were assessed for distraction force and distance, fluid measures, and contact forces used to quantify the suction seal. Exclusion criteria included open surgery, arthroplasty, reorientation osteotomy, or traumatic dislocation.
UNASSIGNED: A total of 33 biomechanical studies comprising 322 hips that evaluated 1 or more of the following were included: distraction force or distance (24 studies), fluid measures (10 studies), and contact forces (6 studies). Compared with a capsulotomy or capsulectomy, capsular repair or reconstruction demonstrated greater resistance to distraction (standardized mean difference [SMD], 1.13; 95% CI, 0.46-1.80; P = .0009). Compared with a labral tear, a labral repair or reconstruction demonstrated less resistance to distraction (SMD, -0.67; 95% CI, -1.25 to -0.09; P = .02). Compared with a labral debridement, repair or reconstruction demonstrated greater resistance to distraction (SMD, 1.74; 95% CI, 1.23 to 2.26; P < .00001). No quantitative analysis was feasible from studies evaluating the effect of osseous resection due to the heterogeneity in methodology and outcome metrics assessed.
UNASSIGNED: Most biomechanical evidence supports capsulotomy repair or reconstruction to improve hip distractive stability at the end of hip arthroscopic surgery. While the repair of a torn labrum does not improve distractive resistance, it is superior to labral debridement in most biomechanical studies.
UNASSIGNED: To investigate the outcome metrics used to quantify hip stability and assess and measure the relative contributions of the labrum, capsule, and bone to hip stability through a quantitative analysis.
UNASSIGNED: Systematic review and meta-analysis; Level of evidence, 4.
UNASSIGNED: PubMed and Embase databases were searched using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included studies evaluated cadaveric hip biomechanics related to capsular, labral, and bony management during hip arthroscopy. Studies were assessed for distraction force and distance, fluid measures, and contact forces used to quantify the suction seal. Exclusion criteria included open surgery, arthroplasty, reorientation osteotomy, or traumatic dislocation.
UNASSIGNED: A total of 33 biomechanical studies comprising 322 hips that evaluated 1 or more of the following were included: distraction force or distance (24 studies), fluid measures (10 studies), and contact forces (6 studies). Compared with a capsulotomy or capsulectomy, capsular repair or reconstruction demonstrated greater resistance to distraction (standardized mean difference [SMD], 1.13; 95% CI, 0.46-1.80; P = .0009). Compared with a labral tear, a labral repair or reconstruction demonstrated less resistance to distraction (SMD, -0.67; 95% CI, -1.25 to -0.09; P = .02). Compared with a labral debridement, repair or reconstruction demonstrated greater resistance to distraction (SMD, 1.74; 95% CI, 1.23 to 2.26; P < .00001). No quantitative analysis was feasible from studies evaluating the effect of osseous resection due to the heterogeneity in methodology and outcome metrics assessed.
UNASSIGNED: Most biomechanical evidence supports capsulotomy repair or reconstruction to improve hip distractive stability at the end of hip arthroscopic surgery. While the repair of a torn labrum does not improve distractive resistance, it is superior to labral debridement in most biomechanical studies.
摘要：
■以前的生物力学研究已经确定了囊关闭，唇修复或重建，骨软骨成形术是改善髋关节稳定性的重要手术干预措施。
■为了研究用于量化髋关节稳定性的结果指标，并评估和测量唇的相对贡献，胶囊,并通过定量分析骨与髋关节的稳定性。
■系统评价和荟萃分析；证据水平，4.
■使用PRISMA（系统评价和荟萃分析的首选报告项目）指南搜索PubMed和Embase数据库。纳入的研究评估了与囊膜相关的尸体髋关节生物力学，Labral,髋关节镜检查期间的骨管理。研究评估了牵引力和距离，流体测量,和用于量化吸入密封的接触力。排除标准包括开放手术，关节成形术,重新定位截骨,或创伤性脱位。
■总共包括33项生物力学研究，包括322个臀部，评估了以下一种或多种：牵引力或距离（24项研究），流体测量(10项研究)，和接触力(6项研究)。与囊切开术或囊切除术相比，囊修复或重建表现出对分散的更大抵抗力(标准化平均差[SMD]，1.13；95%CI，0.46-1.80；P=.0009）。与唇撕裂相比，唇修复或重建显示对分心的抵抗力较小(SMD，-0.67；95%CI，-1.25至-0.09；P=.02）。与唇清创术相比，修复或重建显示出对分心的更大抵抗力(SMD，1.74；95%CI，1.23至2.26；P<.00001）。由于评估方法和结果指标的异质性，评估骨切除效果的研究没有定量分析是可行的。
■大多数生物力学证据支持在髋关节镜手术结束时进行囊切开术修复或重建以改善髋关节分散稳定性。虽然唇撕裂的修复不能改善注意力分散的抵抗力，在大多数生物力学研究中，它优于唇清创术。
■为了研究用于量化髋关节稳定性的结果指标，并评估和测量唇的相对贡献，胶囊,并通过定量分析骨与髋关节的稳定性。
■系统评价和荟萃分析；证据水平，4.
■使用PRISMA（系统评价和荟萃分析的首选报告项目）指南搜索PubMed和Embase数据库。纳入的研究评估了与囊膜相关的尸体髋关节生物力学，Labral,髋关节镜检查期间的骨管理。研究评估了牵引力和距离，流体测量,和用于量化吸入密封的接触力。排除标准包括开放手术，关节成形术,重新定位截骨,或创伤性脱位。
■总共包括33项生物力学研究，包括322个臀部，评估了以下一种或多种：牵引力或距离（24项研究），流体测量(10项研究)，和接触力(6项研究)。与囊切开术或囊切除术相比，囊修复或重建表现出对分散的更大抵抗力(标准化平均差[SMD]，1.13；95%CI，0.46-1.80；P=.0009）。与唇撕裂相比，唇修复或重建显示对分心的抵抗力较小(SMD，-0.67；95%CI，-1.25至-0.09；P=.02）。与唇清创术相比，修复或重建显示出对分心的更大抵抗力(SMD，1.74；95%CI，1.23至2.26；P<.00001）。由于评估方法和结果指标的异质性，评估骨切除效果的研究没有定量分析是可行的。
■大多数生物力学证据支持在髋关节镜手术结束时进行囊切开术修复或重建以改善髋关节分散稳定性。虽然唇撕裂的修复不能改善注意力分散的抵抗力，在大多数生物力学研究中，它优于唇清创术。
