目的:髋关节镜检查可有效治疗髋关节发育不良(BDDH),但是在中国只有很少的临床报道,其术后失败率仍然是一个不容忽视的问题。本研究旨在分析我国髋关节镜治疗BDDH的临床效果,探讨影响髋关节镜治疗BDDH疗效的危险因素。
方法:对我院2017年3月至2022年2月采用关节镜治疗的22例BDDH患者进行回顾性分析。包括10名男性和12名女性,平均年龄34.7±9.5岁(19-53岁)。所有患者均接受关节镜下髋臼成形术治疗,唇修复,股骨骨成形术,和包膜折叠。视觉模拟量表(VAS),改良哈里斯髋关节得分(mHHS),在手术前和随访时测量髋关节结果评分-日常生活活动(HOS-ADL)和国际髋关节结果工具-12(iHOT-12),并进行统计学分析。还获得了最小临床显著差异(MCID)和患者可接受症状状态(PASS)。
结果:22例患者获得随访,随访时间≥1年,平均21.4±8.2个月。术后VAS评分由术前5.27±1.58分下降至随访时1.96±0.92分,差异有统计学意义(t=9.05,P<0.001)。mHHS评分由术前64.84±13.58分提高至随访时90.4±10.11分,差异有统计学意义(t=-7.07,P<0.001)。HOS-ADL评分由术前68.92±11.76分上升至随访时88.91±9.51分,差异有统计学意义(t=-8.15,P<0.001)。iHOT-12评分由术前49.32±12.01分提高至随访时79.61±15.89分,差异有统计学意义(t=-7.66,P<0.001)。MCID(mHHS)和MCID(HOS-ADL)分别为81.8%和77.3%,随访时PASS(mHHS)和PASS(HOS-ADL)分别为86.4%和72.7%。
结论:髋关节镜治疗BDDH可取得良好的短期疗效。
方法:IV治疗性研究。
OBJECTIVE: Hip arthroscopy is effective in treating bordline developmental dysplasia of the
hip (BDDH), but there are only a few clinical reports in China, and its postoperative failure rate is still a problem that cannot be ignored. The aim of this study was to analyze the clinical effect of
hip arthroscopy in BDDH treatment in China and to explore the risk factors influencing the efficacy of
hip arthroscopy in BDDH treatment.
METHODS: All of 22 cases of BDDH treated with arthroscopy in our hospital from November March 2017 to February 2022 were analyzed retrospectively, including ten males and 12 females, with an average age of 34.7 ± 9.5 years (19-53 years). All patients underwent arthroscopic treatment with acetabular plasty, labral repair, femoral osteoplasty, and capsular plication. Visual Analogue Scale (VAS), modified Harris
Hip Scores (mHHS),
Hip Outcome Score-activities of Daily Living (HOS-ADL) and International
Hip Outcome Tool-12 (iHOT-12) were measured before operation and at the follow-up, and statistical analysis was performed. The Minimum clinically significant difference (MCID) and Patient Acceptable Symptom State (PASS) were also obtained.
RESULTS: 22 patients were followed up, and the follow-up time was ≥ one year, with an average of 21.4 ± 8.2 months. The VAS score decreased from 5.27 ± 1.58 points before surgery to 1.96 ± 0.92 points at the follow-up, and the difference was statistically significant (t = 9.05,P < 0.001). The mHHS score increased from 64.84 ± 13.58 points before surgery to 90.4 ± 10.11 points at the follow-up, and the difference was statistically significant (t=-7.07, P < 0.001). The HOS-ADL score increased from 68.92 ± 11.76 points before surgery to 88.91 ± 9.51 points at the follow-up, and the difference was statistically significant (t=-8.15,P < 0.001). The iHOT-12 score increased from 49.32 ± 12.01 points before surgery to 79.61 ± 15.89 points at the follow-up, and the difference was statistically significant (t=-7.66,P < 0.001). The MCID (mHHS) and MCID (HOS-ADL) were 81.8% and 77.3% respectively, and the PASS (mHHS) and PASS (HOS-ADL) were 86.4% and 72.7% respectively at the follow-up.
CONCLUSIONS: Hip arthroscopy can achieve good short-term outcomes in the treatment of BDDH.
METHODS: IV Therapeutic Study.