■临界髋关节发育不良(BHD)和合并股髋臼撞击综合征(FAIS)的患者在短期和中期随访中与无发育不良的同等患者结果相似。然而,这些组间在长期随访中的比较尚待研究.
■比较BHD患者行FAIS初次髋关节镜检查与对照组无BHD患者的长期临床结果。
■队列研究;证据水平,2.
■对BHD患者进行了一项回顾性队列研究(横向中心边缘角,18°-25°),在2012年1月至2013年2月期间接受了FAIS的髋关节镜检查。患者的年龄倾向匹配为1:3,性别,和体重指数控制接受初次髋关节镜检查的无BHD患者。两组患者在术前和术后10年的患者报告结果(PRO)方面进行比较,包括髋关节结果评分日常生活活动分量表(HOS-ADL)和体育分量表(HOS-SS),改良Harris髋关节评分,12项国际髋关节结果工具,疼痛和满意度的视觉模拟量表(VAS)。在组间比较最小临床重要差异(MCID)和患者可接受症状状态(PASS)的成就率。在组间评估Kaplan-Meier生存曲线。
■平均随访10.3±0.3年,28例BHD患者(20名女性;年龄,30.8±10.8年)与接受初次髋关节镜检查的84名对照相匹配。在10年的所有PRO测量中,两组的术前评估均显着改善(全部P<.001)。PRO评分在组间相似,除了HOS-SS(BHD,与对照组相比,62.9±31.9,80.1±26.0;P=.030)。所有专业人员的MCID成就率在组间相似(HOS-ADL:BHD,与对照组相比,76.2%,67.9%,P=.580;HOS-SS:BHD,与对照组相比,63.2%,69.4%,P=.773;改良哈里斯髋关节评分:BHD,与对照组相比,76.5%,67.9%,P=.561;VAS疼痛:BHD,与对照组相比,75.0%,91.7%,P=.110)。HOS-ADL的BHD组的PASS成就率显着降低(BHD,39.1%与对照组相比,77.4%;P=.002),HOS-SS(BHD,与对照组相比,45.5%,84.7%;P=.001),和VAS疼痛(BHD,与对照组相比,50.0%,78.5%;P=.015)。两组之间的指数髋关节后续再手术率无明显差异。Kaplan-Meier生存分析在长期随访中显示出相当的生存率(P=.645)。
■初次髋关节镜检查后,在10年的随访中,FAIS背景下的BHD患者的PRO评分显着改善,与无BHD的倾向匹配对照相当。MCID成绩的比率在组间相似,尽管BHD患者的PASS成功率较低。与对照组相比,BHD患者的长期髋关节镜检查生存率相似,髋关节镜翻修率或转换为全髋关节置换术率无显著差异。
UNASSIGNED: Patients with borderline hip dysplasia (BHD) and concomitant femoroacetabular impingement syndrome (FAIS) have demonstrated similar outcomes at short- and midterm follow-up compared with equivalent patients without dysplasia. However, comparisons between these groups at long-term follow-up have yet to be investigated.
UNASSIGNED: To compare long-term clinical outcomes between patients with BHD undergoing primary hip arthroscopy for FAIS versus matched control patients without BHD.
UNASSIGNED: Cohort
study; Level of evidence, 2.
UNASSIGNED: A retrospective cohort
study was conducted on patients with BHD (lateral center-edge angle, 18°-25°) who underwent hip arthroscopy for FAIS between January 2012 and February 2013. Patients were propensity matched in a 1:3 ratio by age, sex, and body mass index to control patients without BHD who underwent primary hip arthroscopy. Groups were compared in terms of patient-reported outcomes (PROs) preoperatively and at 10 years postoperatively, including the Hip Outcome Score Activities of Daily Living subscale (HOS-ADL) and Sports subscale (HOS-SS), modified Harris Hip Score, 12-item International Hip Outcome Tool, visual analog scale (VAS) for pain and satisfaction. Achievement rates for minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were compared between groups. Kaplan-Meier survivorship curves were assessed between groups.
UNASSIGNED: At a mean follow-up of 10.3 ± 0.3 years, 28 patients with BHD (20 women; age, 30.8 ± 10.8 years) were matched to 84 controls who underwent primary hip arthroscopy. Both groups significantly improved from preoperative assessment in all PRO measures at 10 years (P < .001 for all). PRO scores were similar between groups, aside from HOS-SS (BHD, 62.9 ± 31.9 vs controls, 80.1 ± 26.0; P = .030). Rates of MCID achievement were similar between groups for all PROs (HOS-ADL: BHD, 76.2% vs controls, 67.9%, P = .580; HOS-SS: BHD, 63.2% vs controls, 69.4%, P = .773; modified Harris Hip Score: BHD, 76.5% vs controls, 67.9%, P = .561; VAS pain: BHD, 75.0% vs controls, 91.7%, P = .110). Rates of PASS achievement were significantly lower in the BHD group for HOS-ADL (BHD, 39.1% vs controls, 77.4%; P = .002), HOS-SS (BHD, 45.5% vs controls, 84.7%; P = .001), and VAS pain (BHD, 50.0% vs controls, 78.5%; P = .015). No significant difference was found in the rate of subsequent reoperation on the index hip between groups. Kaplan-Meier survival analysis demonstrated comparable survivorship at long-term follow-up (P = .645).
UNASSIGNED: After primary hip arthroscopy, patients with BHD in the setting of FAIS had significantly improved PRO scores at 10-year follow-up, comparable with propensity-matched controls without BHD. Rates of MCID achievement were similar between groups, although patients with BHD had lower rates of PASS achievement. Patients with BHD had similar long-term hip arthroscopy survivorship compared with controls, with no significant difference in rates of revision hip arthroscopy or conversion to total hip arthroplasty.