■探讨改良关节镜下翻修松解术对臀肌挛缩症患者的临床疗效,以及传统开放手术后效果不佳的患者。
■对传统开放手术后因臀肌挛缩症残留症状行改良关节镜下翻修松解术的患者资料进行回顾性分析。所有受试者在2015年12月至2022年12月期间接受该程序。通过评估特定症状的改善来评估手术疗效。包括双侧下肢不平等,髋关节内旋和内收活动,蹲着,双膝紧压在一起,以及以仰卧姿势交叉双腿的能力,以及术前和术后结果为臀肌挛缩功能量表。进行配对t检验以检查术前和术后测量值之间的差异是否具有统计学意义。
■共36例患者进行了系统随访,平均随访时间为(22.4±4.9)个月。所有患者末次随访时臀肌挛缩功能量表的评分明显高于术前评估结果,术前评分从40.2±5.5提高到78.4±4.9(P<0.05)。在后续行动中,与术前状态相比,所有患者的髋关节内收和内旋活动度均有改善,且所有患者均能在双膝压在一起的情况下蹲下.此外,只有1名患者仍然难以交叉双腿。共有27例(75%)术前存在腿长不均,在后续行动中,所有这些都有不同程度的改善。在所有患者(72髋/例)中,8例皮下血肿及切口瘀斑,在保守治疗如热敷后得到解决。3例表现为髋关节外展肌强度下降,但术后锻炼康复后肌力逐渐恢复。无皮下渗出等并发症,神经血管损伤,或手术部位感染。
■改良关节镜下翻修释放臀肌挛缩适用于常规开放手术后效果较差的病例。
UNASSIGNED: To investigate the clinical efficacy of modified arthroscopic revision release for patients who have gluteal muscle
contracture and who have poor outcomes after traditional open surgery.
UNASSIGNED: The data of patients who underwent modified arthroscopic revision release for residual symptoms of gluteal muscle
contracture after traditional open surgery were retrospectively collected and analyzed. All subjects underwent the procedure between December 2015 and December 2022. The surgical efficacy was assessed by evaluating improvements in specific symptoms, including bilateral lower extremity inequality, hip internal rotation and adduction mobility, squatting with both knees pressed together, and the ability to cross one\'s legs in supine position, as well as the preoperative and postoperative results for the gluteal muscle
contracture functionality scale. Paired t-test was performed to examine whether the differences between preoperative and postoperative measurements were statistically significant.
UNASSIGNED: A total of 36 patients were followed up systematically, with the mean follow-up period being (22.4±4.9) months. All patients had significantly higher scores for assessment with the gluteal muscle
contracture functionality scale at the last follow-up than their preoperative assessment results, showing an increase from the preoperative scores of 40.2±5.5 to 78.4±4.9 (P<0.05). At the follow-up, all patients showed improvement in hip adduction and internal rotation mobility compared with their preoperative status and all patients were able to squat with both knees pressed together. Moreover, only 1 patient still had difficulty in crossing his legs. A total of 27 cases (75%) had preoperative leg length inequality, all of which improved to varying degrees at follow-up. Among all the patients (72 hips/cases), 8 cases had subcutaneous hematomas and incisional ecchymosis, which were resolved after conservative treatments such as hot compresses. 3 cases showed decreased hip abductor strength, but the muscle strength gradually recovered after postoperative exercise and rehabilitation. There were no complications such as subcutaneous exudate, neurovascular injury, or surgical site infection.
UNASSIGNED: Modified arthroscopic revision release of gluteus muscle
contracture is suitable for cases with poor outcomes after conventional open surgery.