目的:本综述的目的是总结股骨髋臼撞击(FAI)行髋关节镜检查的患者的各种包膜管理策略的技术和结果。本综述提供的有关胶囊管理策略的信息将为外科医生在关节镜下管理FAI病变患者提供手术指导和决策。
方法:三个数据库MEDLINE,EMBASE,和PubMed从数据库开始到2021年11月2日进行了检索,以获取有关接受FAI髋关节镜检查的患者的囊管理的文献。记录关于囊袋管理策略的所有I-IV级数据以及术后功能结果。使用随机效应模型对平均术后功能结果进行荟萃分析。
结果:总体而言,本综述共纳入36项研究和4744例患者.非比较研究的平均MINORS评分为10.7(范围8-13),比较研究的平均MINORS评分为17.6(范围15-20)。在1302例患者中,三项比较研究检查了在进行囊膜修复或无修复的门静脉囊切开术的患者中达到mHHS评分的MCID的比例,发现囊膜修复组达到MCID的比值比更高,为1.46(95%CI0.61-3.45,I2=67%,Fig.2,表3);然而,这种差异在p值为0.39时不显著.当只看1级和2级研究时,在1308名患者中,有四项研究报告了接受囊封堵的患者的mHHS评分,无论囊切开术类型如何,发现mHHS评分的汇总标准化平均差为2.1(95%CI1.7-2.55,I2=70%,Fig.3),尽管有4项研究在402名患者中报告了与囊切开术类型无关的未进行囊封口患者的mHHS评分,但发现mHHS评分的汇总标准化平均差为1.46(95%CI1.2-1.7,I2=30%,Fig.4).
结论:本综述可能表明,基于术后mHHS评分,无论囊切开术类型如何,接受完全囊闭合的患者术后结局均有所改善。此外,本综述可能提示门静脉囊切开术闭合后术后结局改善.关于未闭合的T型囊切开术的公开结果数据有限。这篇综述为外科医生在关节镜下治疗FAI病变患者时提供了有关囊管理策略的手术指导。
方法:IV.
OBJECTIVE: The purpose of this
review is to provide a summary of the techniques and outcomes of various capsular management strategies in patients undergoing hip arthroscopy for femoroacetabular impingement (FAI). The information this
review provides on capsular management strategies will provide surgeons with operative guidance and decision-making when managing patients with FAI lesions arthroscopically.
METHODS: Three databases MEDLINE, EMBASE, and PubMed were searched from database inception to November 2nd 2021, for literature addressing capsular management of patients undergoing hip arthroscopy for FAI. All level I-IV data on capsular management strategy as well as postoperative functional outcomes were recorded. A meta-analysis was used to combine the mean postoperative functional outcomes using a random-effects model.
RESULTS: Overall, there were a total of 36 studies and 4744 patients included in this
review. The mean MINORS score was 10.7 (range 8-13) for non-comparative studies and 17.6 (range 15-20) for comparative studies. Three comparative studies in 1302 patients examining the proportion of patients reaching the MCID for the mHHS score in patients undergoing interportal capsulotomy with either capsular repair or no repair found that the capsular repair group had a higher odds ratio of reaching the MCID at 1.46 (95% CI 0.61-3.45, I2 = 67%, Fig. 2, Table 3); however, this difference was not significant with a p value of 0.39. When looking at only level 1 and 2 studies, four studies in 1308 patients reporting on the mHHS score in patients undergoing capsular closure regardless of capsulotomy type, found a pooled standardized mean difference in the mHHS score of 2.1 (95% CI 1.7-2.55, I2 = 70%, Fig. 3), while four studies in 402 patients reporting on the mHHS score in patients not undergoing capsular closure regardless of capsulotomy type found a pooled standardized mean difference in the mHHS score of 1.46 (95% CI 1.2-1.7, I2 = 30%, Fig. 4).
CONCLUSIONS: This review may demonstrate improved postoperative outcomes in patients undergoing complete capsular closure regardless of capsulotomy type based on postoperative mHHS score. Furthermore, this
review may suggest improved postoperative outcomes after closure of an interportal capsulotomy. There are limited published outcome data regarding T-type capsulotomy without closure. This
review provides surgeons with operative guidance on capsular management strategies when treating patients with FAI lesions arthroscopically.
METHODS: IV.