未经授权:股骨髋臼撞击综合征(FAIS)患者接受髋关节镜手术以减轻髋关节疼痛,提高功能,减少髋关节骨关节炎(OA)的发展。尽管如此,长期随访数据很少。
未经评估:为了调查患者报告的结果,临床试验,重新操作,FAIS患者初次髋关节镜检查5年后的影像学状况。
未经批准:案例系列;证据级别,4.
未经批准:共有60名患者(年龄,36±9年;63%的女性)被诊断为FAIS被纳入研究,并在髋关节镜检查后随访5年。随访包括哥本哈根髋关节和腹股沟结果评分(HAGOS);髋关节运动活动量表;和临床试验(屈曲,内收,内旋[FADIR];屈曲,绑架,外部旋转[FABER];和腰大肌/肌腱主要疼痛激发)。影像学评估包括髋关节OA的外侧关节间隙宽度(LJSW)和Tönnis分类。记录再次手术和转换为全髋关节置换术(THR)。我们计算了超过最小重要变化(MIC)的患者比例,达到患者可接受的症状状态(PASS),并且在年龄和性别匹配的无髋关节问题者的95%参考区间内。使用配对t检验调查变化。
UNASSIGNED:与术前相比,所有HAGOS量表在手术后5年均有明显改善(平均值,≥21分;P<.001),67%至89%的患者报告改善超过MIC.在56%到80%之间获得通过,但只有7%至24%达到了HAGOS量表的95%参考区间。共有36%的FADIR试验为阳性,25%的FABER试验为阳性,与术前相比均有改善(两者均P<.001)。FADIR测试阳性的患者的HAGOS分量表明显较差。六名患者(10%)在初次髋关节镜检查后出现THR。在剩下的病人中,平均LJSW下降(-0.4mm;P=.043),9例患者髋部OA恶化(23%;P=.003)。
未经批准:手术后五年,大多数患者的HAGOS改善超过MIC,同时也显示出可接受的PASS.然而,临床试验,参加体育活动,生活质量表明,许多患者仍有髋关节问题。
UNASSIGNED:NCT04590924(ClinicalTrials.gov标识符)。
UNASSIGNED: Patients with femoroacetabular impingement syndrome (FAIS) are offered hip arthroscopic surgery to decrease hip pain, improve their function, and decrease development of hip osteoarthritis (OA). Nonetheless, long-term follow-up data are few.
UNASSIGNED: To investigate patient-reported outcomes, clinical tests, reoperations, and radiographic status 5 years after primary hip arthroscopy in patients with FAIS.
UNASSIGNED: Case series; Level of evidence, 4.
UNASSIGNED: A total of 60 patients (age, 36 ± 9 years; 63% female) diagnosed with FAIS were included in the study and followed for 5 years after hip arthroscopy. Follow-up included Copenhagen Hip and Groin Outcome Score (HAGOS); Hip Sports Activity Scale; and clinical tests (flexion, adduction, internal rotation [FADIR]; flexion, abduction, external rotation [FABER]; and psoas muscle/tendon major pain provocation). Radiographic evaluation included lateral joint-space width (LJSW) and Tönnis classification for hip OA. Reoperations and conversion to total hip replacement (THR) were recorded. We calculated the proportion of patients who exceeded the minimal important change (MIC), achieved the Patient Acceptable Symptom State (PASS), and were within the 95% reference interval of age- and sex-matched persons with no hip problems. Changes were investigated using paired t tests.
UNASSIGNED: Compared with preoperatively, all HAGOS subscales were improved substantially 5 years after surgery (mean, ≥21 points; P < .001), and 67% to 89% of patients reported improvements exceeding MIC. Between 56% and 80% achieved PASS, but only 7% to 24% reached the 95% reference interval for the HAGOS subscales. A total of 36% had a positive FADIR test and 25% had a positive FABER test, which were improvements compared with preoperatively (P < .001 for both). Patients with a positive FADIR test had significantly worse HAGOS subscales. Six patients (10%) had a THR since their primary hip arthroscopy. In the remaining patients, the mean LJSW was decreased (-0.4 mm; P = .043), and hip OA had worsened in 9 patients (23%; P = .003).
UNASSIGNED: Five years after surgery, the majority of patients experienced HAGOS improvements exceeding MIC while also showing an acceptable PASS. However, clinical tests, participation in physical activities, and quality of life indicated that many patients still experience hip problems.
UNASSIGNED: NCT04590924 (ClinicalTrials.gov identifier).