PDF(Pubmed)
Abstract：
UNASSIGNED: The labral suction seal has been shown to provide the majority of resistance in the initial phase of hip distraction. However, the effect of an unrepaired interportal capsulotomy and capsular repair on the initial phase of hip distractive stability in vivo is not well understood.
UNASSIGNED: To investigate the effect of capsular repair on the initial phase of distractive stability of hip joints in patients with femoroacetabular impingement (FAI) syndrome.
UNASSIGNED: Controlled laboratory study.
UNASSIGNED: Patients undergoing primary hip arthroscopy for FAI between March and August 2020 were prospectively enrolled. Total joint space was measured on fluoroscopic images at the medial and lateral edges of the sourcil at 12.5-lb (5.7-kg) axial traction intervals (up to 100 lb [45.4 kg]) in 3 capsular states: (1) native capsule, (2) interportal capsulotomy, and (3) capsular repair. Distraction on anteroposterior radiographs was calculated as the difference between total joint space at each traction interval and baseline joint space at 0 lb, normalized to millimeters. The native, capsulotomy, and capsular repair states were compared using Wilcoxon signed-rank and McNemar tests.
UNASSIGNED: Included were 36 hips in 35 patients. The median force required to distract ≥3 mm was 75 lb (34.0 kg; 95% CI, 70-80 lb [31.8-36.3 kg]) in both the native and capsular repair states (P = .629), which was significantly greater than the median force required to distract ≥3 mm in the capsulotomy state (50 lb [22.7 kg]; 95% CI, 45-55 lb [20.4-24.9 kg]) (P < .001). The most rapid rates of change in joint space were observed at the traction interval at which hips first achieved ≥3 mm of distraction (n = 33 hips; 92%).
UNASSIGNED: The traction force at which hips distracted ≥3 mm was 75 lb (34.0 kg) in both the native capsular and capsular repair states. Significantly less traction force (50 lb [22.7 kg]) distracted hips ≥3 mm in the capsulotomy state. Complete capsular closure after interportal capsulotomy resulted in restoration of initial distractive stability relative to the unrepaired capsulotomy state at time zero after primary hip arthroscopy.
UNASSIGNED: This study provides surgeons with an improved understanding of the additional stability to the hip joint from capsular repair after hip arthroscopy for FAI syndrome.
UNASSIGNED: To investigate the effect of capsular repair on the initial phase of distractive stability of hip joints in patients with femoroacetabular impingement (FAI) syndrome.
UNASSIGNED: Controlled laboratory study.
UNASSIGNED: Patients undergoing primary hip arthroscopy for FAI between March and August 2020 were prospectively enrolled. Total joint space was measured on fluoroscopic images at the medial and lateral edges of the sourcil at 12.5-lb (5.7-kg) axial traction intervals (up to 100 lb [45.4 kg]) in 3 capsular states: (1) native capsule, (2) interportal capsulotomy, and (3) capsular repair. Distraction on anteroposterior radiographs was calculated as the difference between total joint space at each traction interval and baseline joint space at 0 lb, normalized to millimeters. The native, capsulotomy, and capsular repair states were compared using Wilcoxon signed-rank and McNemar tests.
UNASSIGNED: Included were 36 hips in 35 patients. The median force required to distract ≥3 mm was 75 lb (34.0 kg; 95% CI, 70-80 lb [31.8-36.3 kg]) in both the native and capsular repair states (P = .629), which was significantly greater than the median force required to distract ≥3 mm in the capsulotomy state (50 lb [22.7 kg]; 95% CI, 45-55 lb [20.4-24.9 kg]) (P < .001). The most rapid rates of change in joint space were observed at the traction interval at which hips first achieved ≥3 mm of distraction (n = 33 hips; 92%).
UNASSIGNED: The traction force at which hips distracted ≥3 mm was 75 lb (34.0 kg) in both the native capsular and capsular repair states. Significantly less traction force (50 lb [22.7 kg]) distracted hips ≥3 mm in the capsulotomy state. Complete capsular closure after interportal capsulotomy resulted in restoration of initial distractive stability relative to the unrepaired capsulotomy state at time zero after primary hip arthroscopy.
UNASSIGNED: This study provides surgeons with an improved understanding of the additional stability to the hip joint from capsular repair after hip arthroscopy for FAI syndrome.
摘要：
■已显示，在髋部牵引的初始阶段，唇抽吸密封可提供大部分阻力。然而,未修复的门间囊切开术和囊修复对体内髋部分散稳定性初始阶段的影响尚不清楚。
■目的研究囊修复对股骨髋臼撞击（FAI）综合征患者髋关节分散稳定性初始阶段的影响。
■对照实验室研究。
■在2020年3月至8月期间接受FAI原发性髋关节镜检查的患者被前瞻性纳入。在3种囊状状态下，以12.5磅（5.7千克）的轴向牵引间隔（最多100磅[45.4千克]）在源板的内侧和外侧边缘的荧光图像上测量总关节间隙：（1）天然囊，（2）门静脉囊切开术，和(3)囊修复。前后位X线照片上的牵张计算为每个牵拉间隔的总关节间隙与0磅时的基线关节间隙之间的差异。归一化为毫米。本地人,囊切开术,使用Wilcoxon符号秩和McNemar测试比较了囊膜修复状态。
■包括35例患者的36髋。在天然状态和囊膜修复状态下，≥3mm的分散所需的中值力为75磅（34.0千克；95％CI，70-80磅[31.8-36.3千克]）（P=.629），明显大于在囊切开术状态下牵开≥3mm所需的中位力(50lb[22.7kg];95%CI,45-55lb[20.4-24.9kg])(P<.001).在髋关节首次达到≥3mm的牵引间隔处观察到关节间隙的最快变化率（n=33髋；92％）。
■在天然囊和囊修复状态下，臀部撑开≥3mm的牵引力均为75磅（34.0千克）。在囊切开术状态下，牵引力明显减少（50磅[22.7千克]），使臀部撑开≥3毫米。相对于初次髋关节镜检查后的时间零点的未修复的囊切开术状态，门间囊切开术后的完全囊关闭导致初始分散稳定性恢复。
■这项研究为外科医生提供了对FAI综合征的髋关节镜检查后囊修复对髋关节的额外稳定性的更好理解。
■目的研究囊修复对股骨髋臼撞击（FAI）综合征患者髋关节分散稳定性初始阶段的影响。
■对照实验室研究。
■在2020年3月至8月期间接受FAI原发性髋关节镜检查的患者被前瞻性纳入。在3种囊状状态下，以12.5磅（5.7千克）的轴向牵引间隔（最多100磅[45.4千克]）在源板的内侧和外侧边缘的荧光图像上测量总关节间隙：（1）天然囊，（2）门静脉囊切开术，和(3)囊修复。前后位X线照片上的牵张计算为每个牵拉间隔的总关节间隙与0磅时的基线关节间隙之间的差异。归一化为毫米。本地人,囊切开术,使用Wilcoxon符号秩和McNemar测试比较了囊膜修复状态。
■包括35例患者的36髋。在天然状态和囊膜修复状态下，≥3mm的分散所需的中值力为75磅（34.0千克；95％CI，70-80磅[31.8-36.3千克]）（P=.629），明显大于在囊切开术状态下牵开≥3mm所需的中位力(50lb[22.7kg];95%CI,45-55lb[20.4-24.9kg])(P<.001).在髋关节首次达到≥3mm的牵引间隔处观察到关节间隙的最快变化率（n=33髋；92％）。
■在天然囊和囊修复状态下，臀部撑开≥3mm的牵引力均为75磅（34.0千克）。在囊切开术状态下，牵引力明显减少（50磅[22.7千克]），使臀部撑开≥3毫米。相对于初次髋关节镜检查后的时间零点的未修复的囊切开术状态，门间囊切开术后的完全囊关闭导致初始分散稳定性恢复。
■这项研究为外科医生提供了对FAI综合征的髋关节镜检查后囊修复对髋关节的额外稳定性的更好理解。
