■髋关节镜检查治疗临界性髋关节发育不良的短期随访结果令人满意;然而,中期结果的数据不一致,在一些研究中,失败率很高,在该患者队列中限制了对髋关节镜检查的作用和实用性的理解。
■为了提供最新的,在≥5年的随访时间内,对初次髋关节镜检查在初次髋关节镜检查中的临床结局进行循证评价,并报告该队列中的失败率和全髋关节置换术的进展情况.
■系统评价;证据水平,4.
■根据PRISMA(系统评价和荟萃分析的首选报告项目)指南进行了全面的文献检索。如果他们在≥5年随访时评估外侧中心边缘角(LCEA)<25°的患者的初次髋关节镜检查结果,则纳入研究。使用非随机研究的方法学指标评分系统进行偏倚风险评估。使用牛津循证医学中心的标准确定证据水平。
■本综述包括9项研究。LCEA<25°的患者表现出满意的临床结果,患者满意度高,在≥5至10年的随访中,患者报告的结局(PRO)的术后显着改善。比较异型增生患者和非异型增生患者的研究在术前没有显着差异,术后,或deltaPRO或失败,再操作,或修订率。结果与LCEA分层之间没有总体显着相关性。
■在精心选择的LCEA<25°的患者中进行髋关节镜检查可以在中长期随访中取得成功,并且可以提供与LCEA正常患者相当的临床结果和失败率。理解这是一个单数,不区分不稳定性和撞击或其组合的二维射线照相测量,保证未来的研究描述这些差异。这些发现表明,髋关节发育不良可能不是孤立髋关节镜检查的绝对禁忌症,并且考虑到未来的髋臼周围截骨术(PAO),可以作为可行的干预措施。重要的是,这篇综述并不表明髋关节镜检查改变了发育不良的自然史;因此,对于发育不良患者,应由适当的髋关节保护专家就PAO的潜在效用进行咨询.
UNASSIGNED: Hip arthroscopy in patients with borderline hip dysplasia has satisfactory outcomes at short-term follow-up; however, the data on midterm outcomes are inconsistent, and failure rates are high in some studies, limiting understanding of the role and utility of hip arthroscopy in this patient cohort.
UNASSIGNED: To provide an up-to-date, evidence-based review of the clinical outcomes of primary hip arthroscopy in patients with frank or borderline hip dysplasia at ≥5-year follow-up and report the failure rate and progression to total hip arthroplasty in this cohort.
UNASSIGNED: Systematic review; Level of evidence, 4.
UNASSIGNED: A comprehensive literature search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they evaluated outcomes of primary hip arthroscopy in patients with lateral center-edge angle (LCEA) <25° at ≥5-year follow-up. Risk of bias assessment was performed using the methodological index for non-randomized studies scoring system. Level of evidence was determined using criteria from the Oxford Centre for Evidence-Based Medicine.
UNASSIGNED: Nine studies were included in this review. Patients with LCEA <25° demonstrated satisfactory clinical outcomes, high patient satisfaction, and significant postoperative improvements in patient-reported outcomes (PROs) at follow-up ranging from a ≥5 to 10 years. Studies comparing patients with dysplasia to those without did not demonstrate significant differences in preoperative, postoperative, or delta PROs or in failure, reoperation, or revision rates. There was no overall significant correlation between outcomes and LCEA stratification.
UNASSIGNED: Hip arthroscopy in carefully selected patients with LCEA <25° can be successful at mid- to long-term follow-up and may provide clinical outcomes and failure rates comparable with patients with normal LCEA, understanding that this is a singular, 2-dimensional radiographic measure that does not differentiate instability from impingement or combinations thereof, warranting future studies delineating these differences. These findings suggest that hip dysplasia may not be an absolute contraindication for isolated hip arthroscopy and may serve as a viable intervention with consideration of staged future periacetabular osteotomy (PAO). Importantly, this review does not suggest that hip arthroscopy alters the natural history of dysplasia; therefore, patients with dysplasia should be counseled on the potential utility of PAO by appropriate hip preservation specialists.