背景:在2015年,我们描述了一种通过前入路进行髂腰肌杯式撞击的囊增厚技术。据我们所知,中期结果尚未报告。因此,我们回顾性分析了初始系列和2015年以来的所有病例,以通过更长的随访评估这种原始技术:1)分析并发症,和2)评估功能结果。
目的:研究假设是这种手术方案的成功率足以将其纳入髂腰肌撞击的治疗性器械中。
方法:纳入14例患者。九种塑料排在第一线,3肌腱切开术后,和2后换杯。采用了前休特入路,可视化前杯悬垂,有时与前囊的渗透有关,并通过折叠的VicrylTM网实现胶囊增厚。分析功能结果。
结果:在中位4年随访(IQR,2-5;范围,1-9),牛津评分的基线变化为7分(p=0.004),医学研究委员会大腿屈曲力量评分中位数为5分(IQR,5-5),50%的患者(7/14)感到满意或非常满意。主要并发症发生率为7%(1/14),用于1个感染血肿的冲洗,治愈,无复发;大腿外侧皮神经损伤也有1例。43%的患者(6/14)表现出最小的临床重要差异(MCID)和64%(9/14)患者可接受的症状状态(PASS)。解剖CT横向切片的解剖悬垂中位数为7mm(IQR,3-8;范围,0-13)。四名患者接受了二次髋臼成分交换;他们的中悬垂为7.5mm(IQR,7-8)与5毫米(IQR,2-8)适用于其他患者(p值不可计算)。
结论:当髋臼悬垂不太大时,这种手术选择似乎很有趣,尤其是它不影响屈曲强度。
方法:IV.
BACKGROUND: In 2015, we described a capsule-thickening technique via an anterior approach for iliopsoas cup impingement. To our knowledge, medium-term results have not been reported. We therefore retrospectively analyzed all cases in the initial series and those since 2015, to assess this original technique over a longer follow-up: (1) to analyze complications, and (2) to assess functional outcome.
OBJECTIVE: The study hypothesis was that this surgical solution has a success rate sufficient for it to be included in the therapeutic armamentarium for iliopsoas impingement.
METHODS: Fourteen patients were included. Nine plasties were in first line, 3 after tenotomy, and 2 after cup exchange. The anterior Hueter approach was used, visualizing anterior cup overhang, sometimes associated with penetration of the anterior capsule, and enabling capsule-thickening by a folded Vicryl™ mesh. Functional results were analyzed.
RESULTS: At a median 4years\' follow-up (IQR: 2-5; range: 1-9), change over baseline in Oxford score was 7 points (p=0.004), median Medical Research Council thigh flexion strength score was 5 (IQR: 5-5), and 50% of patients (7/14) were satisfied or very satisfied. The major complications rate was 7% (1/14), for 1 irrigation of infected hematoma, cured without recurrence; there was also 1 minor case of injury to the lateral cutaneous nerve of the thigh. Forty-three percent of patients (6/14) exhibited a minimal clinically important difference (MCID) and 64% (9/14) a patient-acceptable symptom state (PASS). Median anatomic overhang on anatomic CT transverse slice was 7mm (IQR: 3-8; range: 0-13). Four patients underwent secondary acetabular component exchange; their median overhang was 7.5mm (IQR: 7-8) compared to 5mm (IQR: 2-8) for the other patients (p-value non-calculable).
CONCLUSIONS: This surgical option seems interesting when acetabular overhang is not too great, especially as it does not affect flexion strength.
METHODS: IV.