PDF(Pubmed)
Abstract：
UNASSIGNED: Arthroscopic treatment of femoroacetabular impingement has increased in popularity since the early 2000s when it was first described, although only a few midterm follow-up studies have been published.
UNASSIGNED: To describe the outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement at a mean 12-year follow-up and to determine the risk factors for failure.
UNASSIGNED: Case-control study; Level of evidence, 3.
UNASSIGNED: The Non-Arthritic Hip Score (NAHS) and a radiographic evaluation were completed preoperatively and at midterm follow-up. Participants were divided into 2 groups according to their clinical evolution. The success group consisted of patients whose NAHS at the final follow-up was above the established Patient Acceptable Symptom State (PASS) threshold of 81.9, whereas patients who underwent a second surgical intervention or did not reach the PASS threshold at final follow-up were assigned to the failure group. These groups were compared to identify preoperative differences in demographic, pathological, and surgical factors.
UNASSIGNED: A total of 95 hips were included, after 23 were lost to follow-up (80.5% follow-up). At a mean follow-up of 12.1 years (range, 9.2-16.0 years), 9 hips required total hip arthroplasty (9.5%), 5 required revision hip arthroscopy (5.3%), 29 did not achieve the NAHS PASS threshold (30.5%), and 52 achieved the NAHS PASS threshold (54.7%). The mean NAHS was 82.4 at final follow-up compared with 66.9 preoperatively (mean difference = 15.5; P < .001). Higher mean body mass index (24.9 vs 23.0; P = .030), older age (30.0 vs 27.2; P = .035), and inferior preoperative lateral joint space width (3.9 vs 4.4; P = .019) were associated with inferior prognosis in the failure group versus success group. Osteoarthritis progression was observed in 69.2% of the failure group and in 34.8% of the success group (P = .082). Labral ossification was observed in 78.3% of all patients, and its lateral projection length was statistically associated with failure (P = .015).
UNASSIGNED: At a mean 12-year follow-up, hip arthroscopy for femoroacetabular impingement led to significant clinical improvement, with 55% PASS achievement. In total, 31% of patients were below the PASS threshold, 5% had revision arthroscopy, and only 9% had conversion to total hip arthroplasty for a 45% global failure rate. Increased body mass index, older age, and smaller preoperative lateral joint space width were significant negative prognostic factors. Postoperative degenerative changes were highly prevalent and demonstrated association with failure.
UNASSIGNED: To describe the outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement at a mean 12-year follow-up and to determine the risk factors for failure.
UNASSIGNED: Case-control study; Level of evidence, 3.
UNASSIGNED: The Non-Arthritic Hip Score (NAHS) and a radiographic evaluation were completed preoperatively and at midterm follow-up. Participants were divided into 2 groups according to their clinical evolution. The success group consisted of patients whose NAHS at the final follow-up was above the established Patient Acceptable Symptom State (PASS) threshold of 81.9, whereas patients who underwent a second surgical intervention or did not reach the PASS threshold at final follow-up were assigned to the failure group. These groups were compared to identify preoperative differences in demographic, pathological, and surgical factors.
UNASSIGNED: A total of 95 hips were included, after 23 were lost to follow-up (80.5% follow-up). At a mean follow-up of 12.1 years (range, 9.2-16.0 years), 9 hips required total hip arthroplasty (9.5%), 5 required revision hip arthroscopy (5.3%), 29 did not achieve the NAHS PASS threshold (30.5%), and 52 achieved the NAHS PASS threshold (54.7%). The mean NAHS was 82.4 at final follow-up compared with 66.9 preoperatively (mean difference = 15.5; P < .001). Higher mean body mass index (24.9 vs 23.0; P = .030), older age (30.0 vs 27.2; P = .035), and inferior preoperative lateral joint space width (3.9 vs 4.4; P = .019) were associated with inferior prognosis in the failure group versus success group. Osteoarthritis progression was observed in 69.2% of the failure group and in 34.8% of the success group (P = .082). Labral ossification was observed in 78.3% of all patients, and its lateral projection length was statistically associated with failure (P = .015).
UNASSIGNED: At a mean 12-year follow-up, hip arthroscopy for femoroacetabular impingement led to significant clinical improvement, with 55% PASS achievement. In total, 31% of patients were below the PASS threshold, 5% had revision arthroscopy, and only 9% had conversion to total hip arthroplasty for a 45% global failure rate. Increased body mass index, older age, and smaller preoperative lateral joint space width were significant negative prognostic factors. Postoperative degenerative changes were highly prevalent and demonstrated association with failure.
摘要：
■自2000年代初首次被描述以来，股骨髋臼撞击的关节镜治疗越来越受欢迎，尽管仅发表了一些中期随访研究。
■描述在平均12年的随访中接受髋关节镜检查股骨髋臼撞击的患者的结果，并确定失败的危险因素。
■病例对照研究；证据水平，3.
■在术前和中期随访时完成非关节炎髋关节评分（NAHS）和影像学评估。根据他们的临床进展将参与者分为2组。成功组由最终随访时NAHS高于既定患者可接受症状状态（PASS）阈值81.9的患者组成，而接受第二次手术干预或最终随访未达到PASS阈值的患者被分配到失败组。对这些组进行比较，以确定术前人口统计学差异，病态,和手术因素。
■总共包括95个臀部，23岁后失访(80.5%随访)。平均随访12.1年(范围，9.2-16.0年)，9髋需要全髋关节置换术（9.5％），5例需要翻修髋关节镜（5.3%），29未达到NAHS通过阈值（30.5%），52达到NAHS通过阈值(54.7%)。最终随访时平均NAHS为82.4，与术前66.9相比（平均差异=15.5；P<.001）。较高的平均体重指数（24.9vs23.0；P=.030），年龄较大（30.0vs27.2；P=.035），术前外侧关节间隙宽度(3.9vs4.4;P=.019)与失败组与成功组的不良预后相关。在失败组的69.2％和成功组的34.8％中观察到骨关节炎进展（P=0.082）。在所有患者中观察到78.3％的唇骨骨化。其横向投影长度与失败有统计学关联(P=.015)。
■在平均12年的随访中，髋关节镜检查股骨髋臼撞击导致显著的临床改善，通过了55%的成绩。总的来说,31%的患者低于PASS阈值，5%有关节镜翻修术，只有9%的患者转行全髋关节置换术,整体失败率为45%.身体质量指数增加，年龄较大,术前外侧关节间隙宽度较小是显著的负面预后因素。术后退行性改变非常普遍，并证明与失败有关。
■描述在平均12年的随访中接受髋关节镜检查股骨髋臼撞击的患者的结果，并确定失败的危险因素。
■病例对照研究；证据水平，3.
■在术前和中期随访时完成非关节炎髋关节评分（NAHS）和影像学评估。根据他们的临床进展将参与者分为2组。成功组由最终随访时NAHS高于既定患者可接受症状状态（PASS）阈值81.9的患者组成，而接受第二次手术干预或最终随访未达到PASS阈值的患者被分配到失败组。对这些组进行比较，以确定术前人口统计学差异，病态,和手术因素。
■总共包括95个臀部，23岁后失访(80.5%随访)。平均随访12.1年(范围，9.2-16.0年)，9髋需要全髋关节置换术（9.5％），5例需要翻修髋关节镜（5.3%），29未达到NAHS通过阈值（30.5%），52达到NAHS通过阈值(54.7%)。最终随访时平均NAHS为82.4，与术前66.9相比（平均差异=15.5；P<.001）。较高的平均体重指数（24.9vs23.0；P=.030），年龄较大（30.0vs27.2；P=.035），术前外侧关节间隙宽度(3.9vs4.4;P=.019)与失败组与成功组的不良预后相关。在失败组的69.2％和成功组的34.8％中观察到骨关节炎进展（P=0.082）。在所有患者中观察到78.3％的唇骨骨化。其横向投影长度与失败有统计学关联(P=.015)。
■在平均12年的随访中，髋关节镜检查股骨髋臼撞击导致显著的临床改善，通过了55%的成绩。总的来说,31%的患者低于PASS阈值，5%有关节镜翻修术，只有9%的患者转行全髋关节置换术,整体失败率为45%.身体质量指数增加，年龄较大,术前外侧关节间隙宽度较小是显著的负面预后因素。术后退行性改变非常普遍，并证明与失败有关。
