目的:调查接受髋关节镜(HA)治疗髋臼撞击综合征(FAIS)的患者报告结果(PROs),髋关节的不规则骨骼生长导致运动过程中的摩擦和疼痛,他们在2年和5年的随访中都有工人赔偿(WC)或无过失保险(NF)与商业保险(CI)。
方法:这是一个单一的中心,单外科医生,2007年8月至2023年5月对连续接受HA的患者进行回顾性分析,一种微创外科手术,用于通过小切口诊断和治疗髋关节内的问题,对于FAIS。患者分为两组-WC/NF患者和商业保险(CI)患者。患者报告结果(PRO),其中包括改良的Harris髋关节评分(mHHS)和非关节炎髋关节评分(NAHS),在术前收集,以及术后至少2年。此外,我们记录了其他临床相关结局变量,包括翻修手术的发生率和转换为全髋关节置换术的发生率.
结果:三百四十三例患者符合纳入标准。WC/NF队列中有32名患者,商业队列中有311名患者。当控制年龄时,性别,和身体质量指数(BMI),在2年(β=-8.190,p<0.01,R2=0.092)和5年(β=-16.60,p<0.01,R2=0.179)和5年随访时NAHS(β=-13.462,p=0.03,R2=0.148),WC/NF状态与mHHS降低相关。在2年的随访中,WC/NF队列对mHHS实现实质性临床获益(SCB)的比率较低(66.7%vs.84.1%,p=0.02)。工人补偿/无故障队列的髋关节镜检查翻修率明显高于商业保险队列(15.6%vs.3.5%,p<0.01)。WC/NF队列中转换为全髋关节置换术(THA)的比率与商业保险队列中转换为THA的比率没有显着差异(0.0%vs.3.2%,p=0.30)。
结论:在短期随访中,接受WC/NF保险的患者在接受FAISHA治疗后,可能会比基线mHHS和NAHS有显著改善。然而,这种改善可能不如CI患者所经历的那样持久.此外,应建议WC/NF患者比类似CI患者接受髋关节镜检查的风险更高。
方法:III,回顾性比较预后调查。
OBJECTIVE: To investigate the patient reported outcomes (PROs) of patients undergoing hip arthroscopy (HA) for femeroacetabular impingement syndrome (FAIS), a condition where irregular bone growth in the hip joint leads to friction and pain during movement, who have worker\'s compensation (WC) or no-fault insurance (NF) versus commercial insurance (CI) at both 2 year and 5 year follow-up.
METHODS: This was a single center, single surgeon, retrospective analysis performed between August 2007 and May 2023 of consecutive patients that underwent HA, a minimally invasive surgical procedure used to diagnose and treat problems inside the hip joint through small incisions, for FAIS. Patients were divided into two cohorts-those with WC/NF and those with commercial insurance (CI). Patient reported outcomes (PROs), which included modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS), were collected preoperatively, as well as at least 2-year postoperatively. Additionally, other clinically relevant outcomes variables including prevalence of revision surgery and conversion to total hip arthroplasty were recorded.
RESULTS: Three hundred and forty three patients met inclusion criteria. There were 32 patients in the WC/NF cohort and 311 patients in the commercial cohort. When controlling for age, sex, and Body Mass Index (BMI), WC/NF status was associated with lower mHHS at both 2 year (β = - 8.190, p < 0.01, R2 = 0.092) and 5 year follow-up (β = - 16.60, p < 0.01, R2 = 0.179) and NAHS at 5 year follow up (β = - 13.462, p = 0.03, R2 = 0.148). The WC/NF cohort had a lower rate of achieving Substantial Clinical Benefit (SCB) for mHHS at 2-years follow-up (66.7% vs. 84.1%, p = 0.02).The rate of revision hip arthroscopy was significantly higher in the worker\'s compensation/no fault cohort than the commercial insurance cohort (15.6% vs. 3.5%, p < 0.01). The rate of conversion to total hip arthroplasty (THA) in the WC/NF cohort was not significantly different than the rate of conversion to THA in the commercial insurance cohort (0.0% vs. 3.2%, p = 0.30).
CONCLUSIONS: Patients with WC/NF insurance may expect a significant improvement from baseline mHHS and NAHS following HA for FAIS at short-term follow-up. However, this improvement may not be as durable as those experienced by patients with CI. Additionally, WC/NF patients should be counseled that they have a higher risk of undergoing revision hip arthroscopy than similar CI patients.
METHODS: III, Retrospective Comparative Prognostic Investigation.