关节镜下盂唇重建治疗髋关节撞击综合征12例

doi:10.19723/j.issn.1671-167X.2021.05.033

摘要/Abstract

Abstract:

To investigate the surgical effect of hip arthroscopic labrum reconstruction. A retrospective study was performed on the clinical data of 12 patients who underwent hip arthroscopic labrum reconstruction in our department from September 2017 to February 2021 and were followed up for 5-46 months, with an average of 21.5 months. All the patients had a hip joint space of more than 2 mm, and Tonnis grade less than level Ⅱ. These 12 patients underwent arthroscopic debridement of hyperplastic synovium, femoral head and neck and/or acetabular osteoplasty, and labrum reconstruction using autograft iliotibial band or gracilis tendon. After the surgery, we conducted follow-up and data collection, recorded the satisfaction of the patients and occurrence of complications, as well as the cartilage lesion of hip joint observed under the arthroscopy. We compared the alpha angle of Dunn X-ray film, center-edge angle (CE angle) of AP X-ray film, modified Harris hip score (mHHS score), hip outcome score (HOS), international hip outcome tool 12 score (iHOT12 Score), and visual analogue scale (VAS scale) before and after the arthroscopic operation, to assess clinical symptom relief and joint function recovery. The 12 patients were followed up for 5-46 (21.5±12.8) months. The VAS scale were (5.3±2.5) and (2.5±1.4) before and after the surgery, showing significant decrease (P=0.018). The mHHS score were (60.6±22.2) and (83.1±5.8) before and after the surgery, showing significant increase (P=0.003). The patient satisfaction was high (7.8±2.0) (range: 0-10). None of the 12 patients had serious complications, revision surgery, or total hip replacement at the end of the last follow-up. Autologous tendon transplantation for reconstruction of acetabular labrum under arthroscopy can improve the clinical symptoms and joint function of patients with femoroacetabular impingement (FAI), which is a safe and effective treatment.

Key words: Femoroacetabular impingment, Hip injuries, Arthroscopes, Transplantation, autologous

中图分类号:

R687.4

董寒梅,吴睿麒,高冠英,刘镕阁,徐雁. 关节镜下盂唇重建治疗髋关节撞击综合征12例[J]. 北京大学学报（医学版）, 2021, 53(5): 1007-1011.

Han-mei DONG,Rui-qi WU,Guan-ying GAO,Rong-ge LIU,Yan XU. Arthroscopic labrum reconstruction for femoroacetabular impingement syndrome: 12 cases report[J]. Journal of Peking University (Health Sciences), 2021, 53(5): 1007-1011.

图/表 6

表1

图1

图2

表2

患者术前、术后髋关节功能和症状改善情况"

Items	Preoperative, $x ?$ ±s	Postoperative, $x ?$ ±s	P value
α angle/(°)	71.7±9.8	50.2±6.1	0.002
CE angle/(°)	37.5±5.2	35.9±3.6	0.099
mHHS	60.6±22.2	83.1±5.8	0.003
HOS-ADL	87.0±6.6	91.8±4.6	0.018
HOS-SS	80.1±14.0	88.7±4.0	0.009
iHOT-12	77.2±11.3	88.8±6.1	0.012
VAS	5.3±2.5	2.5±1.4	0.018

表2

表3

图8

参考文献 25

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Items	Data
Number of patients, n	12
Mean age at surgery/years	35.7 (22-49)^a
Female ∶Male, n	3 ∶9
Mean body mass index	21.8 (16.5-27.5)^a
Side affected (left ∶right), n	5 ∶7
Symptom onset/months	44.2 (8-100)^a
Follow-up/months	21.5 (5-46)^a
Follow-up/%	100

Items	n (%)
Labral lesions	12 (100.0)
Cam-type impingement	3 (25.0)
Pincer-type impingement	0
Mixed-type impingement	9 (75.0)
Acetabular cartilage damage (Outerbridge classification)
0	4 (33.3)
1	0
2	1 (8.3)
3	1 (8.3)
4	6 (50.0)
Femoral cartilage damage (Outerbridge classification)
0	12 (100.0)
1-4	0