目的:本研究的目的是评估和确定在FAI的关节镜骨软骨成形术中什么被认为是适当的影像学矫正,并其次评估影像学结果与患者报告的结果和并发症的关系。
方法:数据库EMBASE,PubMed,从数据库开始到2021年1月,对MEDLINE进行了相关文献搜索。由两名评审员独立和重复筛选研究,以报告FAI的关节镜骨软骨成形术的术后影像学结果。记录影像学结果数据以及报告功能结果和并发症的数据。使用随机效应模型,使用荟萃分析将平均术前和术后影像学结果相结合。使用MINORS评分对所有纳入研究进行偏倚风险评估。
结果:最常见的影像学结果是α角,合并平均术后角度为44°(95%CI41°-46°),手术前后的平均差异为-19°(-22至-16,I2=96%),随后是LCEA,合并平均术后角度为30°(95%CI29-31),手术后平均差异为-4°(-6至-1,I2=97%,).11项研究报告了放射学和临床结果之间的相关性,在纳入的研究中没有发现一致的共识相关性。同样,6项研究将影像学结局与转归THA相关,纳入的研究中未发现一致的一致相关性.
结论:基于这篇综述,主要结论是,对于FAI的最佳影像学校正没有一致的定义,并且影像学校正和功能结局之间没有一致的相关性.然而,基于功能结果的统一改进,本综述建议术后α角目标为44°,矫正目标为19°,LCEA目标为30°,矫正目标为3°.
方法:IV.
OBJECTIVE: The purpose of this study is to evaluate and define what is considered an adequate radiographic correction in arthroscopic osteochondroplasty for FAI and to secondarily assess how radiographic outcomes relate to patient reported outcomes and complications.
METHODS: The databases EMBASE, PubMed, and MEDLINE were searched for relevant literature from database inception until January 2021. Studies were screened by two reviewers independently and in duplicate for studies reporting on post-operative radiographic outcomes in arthroscopic osteochondroplasty for FAI. Data on radiographic outcomes as well as data reporting functional outcomes and complications were recorded. A meta-analysis was used to combine the mean pre- and post-operative radiographic outcomes using a random effects model. A risk of bias assessment was performed for all included studies using the MINORS score.
RESULTS: The most commonly reported radiographic outcome was the alpha angle with a pooled mean post-operative angle of 44° (95% CI 41°-46°), and mean pre- to post-surgical difference of - 19° (- 22 to - 16, I2 = 96%), followed by the LCEA with a pooled mean post-operative angle of 30° (95% CI 29-31) and mean difference after surgery of - 4° (- 6 to - 1, I2 = 97%,). Eleven studies reported on the correlation between radiographic and clinical outcomes with no consistent
consensus correlation found amongst the included studies. Similarly, six studies correlated radiographic outcomes with conversion to THA with no consistent
consensus correlation found amongst the included studies.
CONCLUSIONS: Based on this review, the main conclusion is that there is no
consensus definition on the optimal radiographic correction for FAI and there was no consistent correlation between radiographic correction and functional outcomes. However, based on the uniform improvement in functional outcomes, this review suggests a post-operative alpha angle target of 44° with a correction target of 19° and LCEA target of 30° with a correction target of 3°.
METHODS: IV.