PDF(Pubmed)
Abstract：
UNASSIGNED: An accurate and objective criterion is needed to determine candidates who are suitable for hip arthroscopy in patients with femoroacetabular impingement (FAI).
UNASSIGNED: To determine whether improvement in pain after ultrasound (US)-guided intra-articular hip injection during standardized examinations can be used to predict the outcomes of hip arthroscopy in patients with FAI.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: We enrolled 119 patients with FAI who underwent US-guided intra-articular hip injection of local anesthesia during standardized examinations, carried out from May 2018 to February 2020 (within 2 weeks before hip arthroscopy). All patients had undergone a minimum of 6 months of nonoperative treatment without remission and had 2-year follow-up data. Pain visual analog scale (VAS) scores (0-10) were recorded for 7 different physical examination tests, and a total score (0 [best] to 70 [worst]) was obtained. In addition, International Hip Outcome Tool-12 (iHOT-12) and modified Harris Hip Score (mHHS) scores were recorded before hip arthroscopy and at final follow-up. According to whether patients achieved the substantial clinical benefit (SCB) on the iHOT-12, they were divided into SCB and non-SCB groups, and the improvement in VAS pain scores from preinjection to postinjection (ΔVAS pain) was compared between the 2 groups. Logistic regression analysis was used to predict the achievement of SCB, and the area under the receiver operating characteristic curve (AUC) was used to estimate the accuracy of the prediction.
UNASSIGNED: There was a significant pre- to postoperative increase in iHOT-12 (31.6 points; P < .001) and mHHS (20.0 points; P < .001) scores, and 84 (70.6%) patients achieved the SCB. The ΔVAS pain score was significantly greater in the SCB versus the non-SCB group (16.0 vs 7.0 points; respectively; P < .001). Logistic regression analysis demonstrated an optimal cutoff value of 8.5 points for ΔVAS pain (AUC, 0.772; 95% CI, 0.687-0.858). For patients with more severe symptoms (total preinjection VAS pain score of >10 out of 70), the accuracy of the prediction for ΔVAS pain had a better evaluation value (AUC, 0.834; 95% CI, 0.676-0.992).
UNASSIGNED: Improvement in pain after US-guided intra-articular hip injection predicted the outcomes of hip arthroscopy in patients with FAI in this study, especially for patients with more severe pain.
UNASSIGNED: To determine whether improvement in pain after ultrasound (US)-guided intra-articular hip injection during standardized examinations can be used to predict the outcomes of hip arthroscopy in patients with FAI.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: We enrolled 119 patients with FAI who underwent US-guided intra-articular hip injection of local anesthesia during standardized examinations, carried out from May 2018 to February 2020 (within 2 weeks before hip arthroscopy). All patients had undergone a minimum of 6 months of nonoperative treatment without remission and had 2-year follow-up data. Pain visual analog scale (VAS) scores (0-10) were recorded for 7 different physical examination tests, and a total score (0 [best] to 70 [worst]) was obtained. In addition, International Hip Outcome Tool-12 (iHOT-12) and modified Harris Hip Score (mHHS) scores were recorded before hip arthroscopy and at final follow-up. According to whether patients achieved the substantial clinical benefit (SCB) on the iHOT-12, they were divided into SCB and non-SCB groups, and the improvement in VAS pain scores from preinjection to postinjection (ΔVAS pain) was compared between the 2 groups. Logistic regression analysis was used to predict the achievement of SCB, and the area under the receiver operating characteristic curve (AUC) was used to estimate the accuracy of the prediction.
UNASSIGNED: There was a significant pre- to postoperative increase in iHOT-12 (31.6 points; P < .001) and mHHS (20.0 points; P < .001) scores, and 84 (70.6%) patients achieved the SCB. The ΔVAS pain score was significantly greater in the SCB versus the non-SCB group (16.0 vs 7.0 points; respectively; P < .001). Logistic regression analysis demonstrated an optimal cutoff value of 8.5 points for ΔVAS pain (AUC, 0.772; 95% CI, 0.687-0.858). For patients with more severe symptoms (total preinjection VAS pain score of >10 out of 70), the accuracy of the prediction for ΔVAS pain had a better evaluation value (AUC, 0.834; 95% CI, 0.676-0.992).
UNASSIGNED: Improvement in pain after US-guided intra-articular hip injection predicted the outcomes of hip arthroscopy in patients with FAI in this study, especially for patients with more severe pain.
摘要：
■需要一个准确而客观的标准来确定适合股骨髋臼撞击（FAI）患者进行髋关节镜检查的候选人。
■确定标准化检查期间超声（US）引导关节内髋关节注射后疼痛的改善是否可用于预测FAI患者髋关节镜检查的结果。
■队列研究；证据水平，3.
■我们纳入了119例FAI患者，这些患者在标准化检查期间接受了US引导的关节腔内髋关节注射局部麻醉，于2018年5月至2020年2月进行（髋关节镜检查前2周内）。所有患者都接受了至少6个月的非手术治疗，但没有缓解，并且有2年的随访数据。记录7种不同体格检查测试的疼痛视觉模拟量表(VAS)评分(0-10),并获得总分(0[最佳]至70[最差])。此外,在髋关节镜检查前和最后随访时记录国际髋关节结果工具-12（iHOT-12）和改良的Harris髋关节评分（mHHS）评分。根据患者是否在iHOT-12上获得了实质性的临床益处（SCB），他们被分为SCB和非SCB组，比较两组注射前至注射后VAS疼痛评分的改善情况(ΔVAS疼痛)。Logistic回归分析用于预测SCB的成就，接收器工作特征曲线下面积（AUC）用于估计预测的准确性。
■iHOT-12（31.6分；P<.001）和mHHS（20.0分；P<.001）评分在术后前后显着增加，84例（70.6%）患者达到SCB。SCB组的ΔVAS疼痛评分明显高于非SCB组（分别为16.0和7.0分；P<.001）。Logistic回归分析显示ΔVAS疼痛的最佳临界值为8.5分（AUC，0.772；95%CI，0.687-0.858）。对于症状更严重的患者（总注射前VAS疼痛评分>70分之10），ΔVAS疼痛预测的准确性具有更好的评估价值(AUC，0.834；95%CI，0.676-0.992）。
■在本研究中，超声引导下关节腔内髋关节注射后疼痛的改善预测了FAI患者髋关节镜检查的结果，特别是对于疼痛更严重的患者。
■确定标准化检查期间超声（US）引导关节内髋关节注射后疼痛的改善是否可用于预测FAI患者髋关节镜检查的结果。
■队列研究；证据水平，3.
■我们纳入了119例FAI患者，这些患者在标准化检查期间接受了US引导的关节腔内髋关节注射局部麻醉，于2018年5月至2020年2月进行（髋关节镜检查前2周内）。所有患者都接受了至少6个月的非手术治疗，但没有缓解，并且有2年的随访数据。记录7种不同体格检查测试的疼痛视觉模拟量表(VAS)评分(0-10),并获得总分(0[最佳]至70[最差])。此外,在髋关节镜检查前和最后随访时记录国际髋关节结果工具-12（iHOT-12）和改良的Harris髋关节评分（mHHS）评分。根据患者是否在iHOT-12上获得了实质性的临床益处（SCB），他们被分为SCB和非SCB组，比较两组注射前至注射后VAS疼痛评分的改善情况(ΔVAS疼痛)。Logistic回归分析用于预测SCB的成就，接收器工作特征曲线下面积（AUC）用于估计预测的准确性。
■iHOT-12（31.6分；P<.001）和mHHS（20.0分；P<.001）评分在术后前后显着增加，84例（70.6%）患者达到SCB。SCB组的ΔVAS疼痛评分明显高于非SCB组（分别为16.0和7.0分；P<.001）。Logistic回归分析显示ΔVAS疼痛的最佳临界值为8.5分（AUC，0.772；95%CI，0.687-0.858）。对于症状更严重的患者（总注射前VAS疼痛评分>70分之10），ΔVAS疼痛预测的准确性具有更好的评估价值(AUC，0.834；95%CI，0.676-0.992）。
■在本研究中，超声引导下关节腔内髋关节注射后疼痛的改善预测了FAI患者髋关节镜检查的结果，特别是对于疼痛更严重的患者。
