UNASSIGNED: To evaluate long-term patient-reported outcomes (PROs) and survival, and to determine the potential effect of residual loose bodies, as evaluated by immediate postoperative computed tomography (CT), on clinical outcomes.
UNASSIGNED: Case series; Level of evidence, 4.
UNASSIGNED: A consecutive cohort of patients undergoing arthroscopic treatment and diagnosed with synovial chondromatosis between March 2010 and May 2015 were included in the study. Preoperative radiography, CT, and magnetic resonance imaging were performed. Preoperative, midterm (minimum of 4 years), and long-term (minimum of 8 years) PROs were collected for visual analog scale for pain, modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and 12-item international Hip Outcome Tool (iHOT-12). The percentages achieving minimal clinically important difference (MCID) were calculated. PROs and survival were compared between patients with and without residual loose bodies evident on immediate postoperative CT scan.
UNASSIGNED: A total of 28 patients (20% of patients were lost to follow-up) were included in the study with a mean follow-up period of 104.9 months (range, 96-139 months). PROs including visual analog scale for pain (preoperative, 3.8 ± 1.2; midterm, 0.9 ± 1.7; long-term, 0.8 ± 1.4), mHHS (preoperative, 66.4 ± 14.4; midterm, 92.8 ± 12.3; long-term, 93.5 ± 10.5), NAHS (preoperative, 45.2 ± 16.2; midterm, 81.8 ± 15.3; long-term, 83.1 ± 12.9), and iHOT-12 (preoperative, 48.4 ± 15.6; midterm, 69.3 ± 11.7; long-term, 72.7 ± 11.4) were improved at both midterm and long-term follow-up (all with P < .001). In total, 27 (96.4%), 28 (100%), and 26 (92.9%) patients achieved MCID for mHHS, NAHS and iHOT-12, respectively, at the long-term follow-up. No significant difference was found in any of the PROs and the rate of achieving MCID between midterm and long-term follow-up (all with P > .05). One patient (3.6%) underwent revision surgery. Among the 23 patients who had loose bodies on preoperative CT or radiographs, 14 patients (60.9%) with residual loose bodies evident on immediate postoperative CT demonstrated lower NAHS (P = .045) and iHOT-12 (P = .037) scores but a comparable survival (P > .05) at long-term follow-up compared with those who did not have loose bodies.
UNASSIGNED: Arthroscopic treatment for hip synovial chondromatosis achieved satisfactory long-term clinical outcomes with strong survival. Most patients maintained or improved their overall functional status between midterm and long-term follow-up. Furthermore, patients with residual loose bodies had less favorable clinical outcomes, although the survival rate was comparable.
■为了评估患者报告的长期结局(PRO)和生存率,并确定残余松散体的潜在影响,通过术后即刻计算机断层扫描(CT)评估,关于临床结果。
■案例系列;证据级别,4.
在2010年3月至2015年5月期间接受关节镜治疗并被诊断为滑膜软骨瘤病的连续队列患者被纳入研究。术前射线照相,CT,并进行磁共振成像。术前,中期(至少4年),并收集长期(至少8年)的PRO用于疼痛的视觉模拟量表,改良哈里斯髋关节评分(mHHS),非关节炎髋关节评分(NAHS),和12项国际髋关节结果工具(iHOT-12)。计算实现最小临床重要差异(MCID)的百分比。在术后立即进行CT扫描时,比较了有和没有残留松散身体的患者的PROs和生存率。
■共有28名患者(20%的患者失去了随访)被纳入研究,平均随访期为104.9个月(范围,96-139个月)。PROs包括疼痛的视觉模拟量表(术前,3.8±1.2;中期,0.9±1.7;长期,0.8±1.4),mHHS(术前,66.4±14.4;中期,92.8±12.3;长期,93.5±10.5),NAHS(术前,45.2±16.2;中期,81.8±15.3;长期,83.1±12.9),和iHOT-12(术前,48.4±15.6;中期,69.3±11.7;长期,72.7±11.4)在中期和长期随访中均有所改善(均P<.001)。总的来说,27(96.4%),28(100%),26例(92.9%)患者获得mHHS的MCID,NAHS和iHOT-12,分别在长期随访中。在中期和长期随访之间,任何PRO和实现MCID的比率均无显著差异(均P>0.05)。1例患者(3.6%)接受了翻修手术。在23例在术前CT或X线片上有松散身体的患者中,14例患者(60.9%)在术后即刻CT上显示出明显的残余松散体,其NAHS(P=.045)和iHOT-12(P=.037)评分较低,但长期生存率(P>.05)与没有松散体的患者相比。
■关节镜治疗髋关节滑膜软骨瘤病取得了满意的长期临床疗效和较强的生存率。大多数患者在中期和长期随访之间维持或改善了他们的整体功能状态。此外,残留有松散身体的患者临床结局较差,尽管生存率相当。