开放与关节镜治疗凸轮型股骨髋臼撞击症比较  

Open operation versus hip arthroscopy for treatment of cam-type femoroacetabular impingement

作　　者：王婕 苗茜 刘俊 WANG Jie;MIAO Qian;LIU Jun(Qingdao Municipal Hospital,Qingdao 266000,China)

机构地区：[1]青岛市市立医院,山东青岛266000

出　　处：《中国矫形外科杂志》2021年第20期1901-1904,共4页Orthopedic Journal of China

摘　　要：[目的]比较开放与关节镜术治疗凸轮型股骨髋臼撞击症(femoroacetabular impingement,FAI)的临床疗效。[方法]2018年1月-2019年12月,本科手术治疗凸轮型FAI患者57例。其中,27例采用开放手术治疗(开放组),30例采用髋关节镜治疗(镜下组)。比较两组患者围手术期、随访与影像资料。[结果]两组患者均顺利完成手术。镜下组患者的手术时间、手术切口长度、术中出血量及下地行走时间均显著优于开放组(P<0.05)。开放组早期并发症率为18.51%,镜下组为3.33%,两组差异有统计学意义(P<0.05)。末次随访时两组患者VAS评分、Harris评分、屈髋ROM和屈曲90°内旋ROM均较术前显著改善(P<0.05),镜下组的VAS评分、Harris评分、屈髋ROM和屈曲90。内旋ROM均显著优于开放组(P<0.05)。影像方面,术后两组患者的a角均较术前显著减少(P<0.05)。末次随访时,开放组的a角显著小于镜下组(P<0.05)。[结论]髋关节镜下治疗凸轮型FAI的临床效果优于开放手术。[Objective]To compare the clinical outcomes of open operation versus hip arthroscopy for cam-type femoroacetabular impingement(FAI).[Methods]From January 2018 to December 2019,57 patients underwent surgical treatment for cam-type FAI in our hospital.Of them,27 patients received open operation by surgical dislocation,while the remaining 30 patients had hip arthroscopy performed.The documents of the perioperative period,follow-up and radiographs were compared between the two groups.[Results]All patients in both groups had surgical procedures finished successfully.The arthroscopic group proved significantly superior to the open group regarding operation time,incision length,intraoperative blood loss and time to return ambulation(P<0.05).The rate of early complication was of 18.51%in the open group,whereas 3.33%in the arthroscopic group,which was statistically significant(P<0.05).At the latest follow-up,the VAS score,Harris score,hip flexion range of motion(ROM)and internal rotation ROM at 90°of flexion significantly improved in both groups compared with those before operation(P<0.05).The arthroscopic group proved significantly superior to the open group in aforesaid items at the final interview(P<0.05).In term of radiographic evaluation,the a angle significantly reduced in both groups at the latest follow-up with comparison of those before operation(P<0.05),and the angle in the open group was significantly less than the arthroscopic group(P<0.05).[Conclusion]The hip arthroscopy does achieve clinical outcomes considerably superior to the open operation for cam-type femoroacetabular impingement.

关 键 词：凸轮型 股骨髋臼撞击症 髋关节镜术 开放手术 髋关节外科脱位 

分 类 号：R687.4[医药卫生—骨科学]