PDF(Pubmed)
Abstract：
UNASSIGNED: In the setting of femoroacetabular impingement (FAI), decompression osteoplasties reconcile deleterious loading patterns caused by cam and pincer lesions. However, native variations of spinopelvic sagittal alignment may continue to perpetuate detrimental effects on the labrum, chondrolabral junction, and articular cartilage after hip arthroscopy.
UNASSIGNED: To evaluate the effect of pelvic incidence (PI) on postoperative outcomes after hip arthroscopy for acetabular labral tears in the setting of FAI.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: A retrospective query of prospectively collected data identified patients ≥18 years of age who underwent primary hip arthroscopy for FAI and acetabular labral tears between February 2014 and January 2022, with 3-, 6-, 12-, and 24-month follow-ups. Measurements for PI, pelvic tilt (PT), sacral slope (SS), and acetabular version were obtained via advanced diagnostic imaging. Patients were stratified into low-PI (<45°), moderate-PI (45°≤ PI ≤ 60°), and high-PI (>60°) cohorts. Patient-reported outcome measures (PROMs), clinically meaningful outcomes (ie, minimal clinically important difference, Patient Acceptable Symptom State, substantial clinical benefit, and maximal outcome improvement), visual analog scale (VAS) pain scores, and patient satisfaction were compared across cohorts.
UNASSIGNED: A total of 74 patients met eligibility criteria and were stratified into low-PI (n = 28), moderate-PI (n = 31), and high-PI (n = 15) cohorts. Correspondingly, patients with high PI displayed significantly greater values for PT (P = .001), SS (P < .001), acetabular version (P < .001), and acetabular inclination (P = .049). By the 12- and 24-month follow-ups, the high-PI cohort was found to have significantly inferior PROMs, VAS pain scores, rates of clinically meaningful outcome achievement, and satisfaction relative to patients with moderate and/or low PI. No significant differences were found between cohorts regarding rates of revision arthroscopy, subsequent spine surgery, or conversion to total hip arthroplasty.
UNASSIGNED: After hip arthroscopy, patients with a high PI (>60°) exhibited inferior PROMs, rates of achieving clinically meaningful thresholds, and satisfaction at 12 and 24 months relative to patients with low or moderate PI. Conversely, the outcomes of patients with low PI (<45°) were found to match the trajectory of those with a neutral spinopelvic alignment (45°≤ PI ≤ 60°). These findings highlight the importance of analyzing spinopelvic parameters preoperatively to prognosticate outcomes before hip arthroscopy for acetabular labral tears and FAI.
UNASSIGNED: To evaluate the effect of pelvic incidence (PI) on postoperative outcomes after hip arthroscopy for acetabular labral tears in the setting of FAI.
UNASSIGNED: Cohort study; Level of evidence, 3.
UNASSIGNED: A retrospective query of prospectively collected data identified patients ≥18 years of age who underwent primary hip arthroscopy for FAI and acetabular labral tears between February 2014 and January 2022, with 3-, 6-, 12-, and 24-month follow-ups. Measurements for PI, pelvic tilt (PT), sacral slope (SS), and acetabular version were obtained via advanced diagnostic imaging. Patients were stratified into low-PI (<45°), moderate-PI (45°≤ PI ≤ 60°), and high-PI (>60°) cohorts. Patient-reported outcome measures (PROMs), clinically meaningful outcomes (ie, minimal clinically important difference, Patient Acceptable Symptom State, substantial clinical benefit, and maximal outcome improvement), visual analog scale (VAS) pain scores, and patient satisfaction were compared across cohorts.
UNASSIGNED: A total of 74 patients met eligibility criteria and were stratified into low-PI (n = 28), moderate-PI (n = 31), and high-PI (n = 15) cohorts. Correspondingly, patients with high PI displayed significantly greater values for PT (P = .001), SS (P < .001), acetabular version (P < .001), and acetabular inclination (P = .049). By the 12- and 24-month follow-ups, the high-PI cohort was found to have significantly inferior PROMs, VAS pain scores, rates of clinically meaningful outcome achievement, and satisfaction relative to patients with moderate and/or low PI. No significant differences were found between cohorts regarding rates of revision arthroscopy, subsequent spine surgery, or conversion to total hip arthroplasty.
UNASSIGNED: After hip arthroscopy, patients with a high PI (>60°) exhibited inferior PROMs, rates of achieving clinically meaningful thresholds, and satisfaction at 12 and 24 months relative to patients with low or moderate PI. Conversely, the outcomes of patients with low PI (<45°) were found to match the trajectory of those with a neutral spinopelvic alignment (45°≤ PI ≤ 60°). These findings highlight the importance of analyzing spinopelvic parameters preoperatively to prognosticate outcomes before hip arthroscopy for acetabular labral tears and FAI.
摘要：
■在股髋臼撞击（FAI）的设置中，减压骨成形术可以调和凸轮和钳形病变引起的有害负荷模式。然而,脊柱骨盆矢状位的天然变化可能会继续对唇唇产生有害影响，软骨唇接合处，髋关节镜检查后的关节软骨。
■评估骨盆发生率（PI）对FAI设置下髋臼唇撕裂行髋关节镜检查术后结果的影响。
■队列研究；证据水平，3.
■对前瞻性收集的数据的回顾性查询确定，年龄≥18岁的患者在2014年2月至2022年1月期间接受了FAI和髋臼唇撕裂的初次髋关节镜检查，其中3-，6-，12-，和24个月的随访。PI的测量，骨盆倾斜(PT),骶骨斜坡(SS),和髋臼版本是通过高级诊断成像获得的。患者被分层为低PI（<45°），中等PI(45°≤PI≤60°),和高PI（>60°）队列。患者报告结果测量(PROM)，临床上有意义的结果(即，最小的临床重要差异，患者可接受的症状状态，实质性的临床益处，和最大的结果改善)，视觉模拟量表（VAS）疼痛评分，和患者满意度在不同队列中进行比较.
■共有74名患者符合资格标准，并被分层为低PI（n=28），中度PI（n=31），和高PI（n=15）队列。相应地,高PI患者的PT值明显更大（P=.001），SS（P<.001），髋臼版本（P<.001），和髋臼倾斜（P=0.049）。通过12个月和24个月的随访，发现高PI队列的PROM明显较差，VAS疼痛评分,临床上有意义的结果成就率，相对于中度和/或低PI患者的满意度。在关节镜翻修率方面，队列之间没有发现显着差异。随后的脊柱手术，或转换为全髋关节置换术。
■髋关节镜检查后，高PI(>60°)的患者表现出较差的PROM，达到临床意义阈值的比率，和满意度在12个月和24个月相对于低或中度PI患者。相反，发现低PI(<45°)患者的结局与中性脊柱肾盂排列(45°≤PI≤60°)患者的结局一致.这些发现强调了在髋关节镜检查髋臼唇撕裂和FAI之前，术前分析脊柱骨盆参数对预后结果的重要性。
■评估骨盆发生率（PI）对FAI设置下髋臼唇撕裂行髋关节镜检查术后结果的影响。
■队列研究；证据水平，3.
■对前瞻性收集的数据的回顾性查询确定，年龄≥18岁的患者在2014年2月至2022年1月期间接受了FAI和髋臼唇撕裂的初次髋关节镜检查，其中3-，6-，12-，和24个月的随访。PI的测量，骨盆倾斜(PT),骶骨斜坡(SS),和髋臼版本是通过高级诊断成像获得的。患者被分层为低PI（<45°），中等PI(45°≤PI≤60°),和高PI（>60°）队列。患者报告结果测量(PROM)，临床上有意义的结果(即，最小的临床重要差异，患者可接受的症状状态，实质性的临床益处，和最大的结果改善)，视觉模拟量表（VAS）疼痛评分，和患者满意度在不同队列中进行比较.
■共有74名患者符合资格标准，并被分层为低PI（n=28），中度PI（n=31），和高PI（n=15）队列。相应地,高PI患者的PT值明显更大（P=.001），SS（P<.001），髋臼版本（P<.001），和髋臼倾斜（P=0.049）。通过12个月和24个月的随访，发现高PI队列的PROM明显较差，VAS疼痛评分,临床上有意义的结果成就率，相对于中度和/或低PI患者的满意度。在关节镜翻修率方面，队列之间没有发现显着差异。随后的脊柱手术，或转换为全髋关节置换术。
■髋关节镜检查后，高PI(>60°)的患者表现出较差的PROM，达到临床意义阈值的比率，和满意度在12个月和24个月相对于低或中度PI患者。相反，发现低PI(<45°)患者的结局与中性脊柱肾盂排列(45°≤PI≤60°)患者的结局一致.这些发现强调了在髋关节镜检查髋臼唇撕裂和FAI之前，术前分析脊柱骨盆参数对预后结果的重要性。
