METHODS: A systematic review was conducted adhering to the PRISMA guidelines. Relevant studies were searched in four databases: Pubmed, Scopus, Embase, and Medline. The selected articles were evaluated according to the criteria of levels of evidence. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) was used to analyze the retrospective studies. This paper was registered in the International Prospective Registry of Systematic Reviews (PROSPERO).
RESULTS: Out of 9 included studies, 403 patients with 689 hips underwent endoscopic treatment. ITB release and his variations were the main surgical techniques. Gluteus maximus tenotomy was also used in some studies. Postoperative rehabilitation protocols varied. Patients generally experienced significant improvements in symptoms and functional outcomes, with low rates of recurrence (1.02%) and revision (0.15%). Complications were minimal.
CONCLUSIONS: Endoscopic treatment of ESH shows favorable results, improving functional outcomes and returning patients to pre-injury activity levels. Long-term efficacy and costeffectiveness need to be evaluated, emphasizing the importance of large-scale prospective randomized trials to clarify surgery\'s benefits in refractory ESH cases.
方法:根据PRISMA指南进行系统评价。在四个数据库中搜索了相关研究:Pubmed,Scopus,Embase,Medline根据证据水平标准对所选文章进行评估。非随机干预研究中的偏倚风险(ROBINS-I)用于分析回顾性研究。本文已在国际前瞻性系统审查登记处(PROSPERO)注册。
结果:在9项纳入研究中,403例689髋患者接受内镜治疗。ITB释放和他的变化是主要的手术技术。在一些研究中也使用了臀大肌截割术。术后康复方案各不相同。患者通常经历了症状和功能结果的显着改善,复发率(1.02%)和翻修率(0.15%)低。并发症很少。
结论:ESH的内镜治疗显示出良好的效果,改善功能结局,使患者恢复到损伤前的活动水平。需要评估长期疗效和成本效益,强调大规模前瞻性随机试验的重要性,以阐明手术治疗难治性ESH的益处。