髋关节镜手术治疗钳夹型股骨髋臼撞击征  

Clinical outcomes of hip arthroscopy for treatment of pincer-type femoroacetabular impingement

作　　者：王江涛 李海鹏[3] 张佳 肇刚 王明新 王龙 王耀霆 李春宝 刘玉杰 WANG Jiang-tao;LI Hai-peng;ZHANG Jia;ZHAO Gang;WANG Ming-xin;WANG-Long;WANG Yao-ting;LI Chun-bao;LIU Yu-jie(Medical College of CPLA,Beijing 100853,China;Department of Orthopedics,980h Hospital,Joint Logistic Support Force of CPLA,Shijiazhuang 050082,China;Department of Orthopaedic Medicine,The Fourth Medical Center,General Hospital of CPLA,Beijing 100853,China)

机构地区：[1]解放军医学院,北京100853 [2]中国人民解放军联勤保障部队第九八○医院骨一科,河北石家庄050082 [3]中国人民解放军总医院第四医学中心骨科医学部,北京100853

出　　处：《中国矫形外科杂志》2022年第5期388-392,共5页Orthopedic Journal of China

基　　金：国家自然科学基金面上项目(编号:82072517);国家重点研发计划科技冬奥专项基金项目(编号:2018YFF0301100)。

摘　　要：[目的]探讨髋关节镜下髋臼成形术治疗钳夹型股骨髋臼撞击征的疗效.[方法]回顾性分析2017年6月—2019年7月本科收治的钳夹型股骨髋臼撞击征患者24例.其中,男10例,女14例,平均年龄(33.52±11.42)岁,手术方式均为髋关节镜下髋臼成形术.[结果]所有患者均顺利手术,镜下证实24例患者均为单纯钳夹型撞击,无股骨头颈交界凸轮骨赘.切口均一期愈合,无关节内感染、股骨头坏死、深静脉栓塞、下肢神经损伤等并发症.24例患者随访12个月以上.与术前相比,术后6个月和末次随访时24例患者FADIR和FABER试验均显著改善(P<0.05),VAS评分均显著减少(P<0.05),而mHHS和iHOT-12评分均显著增加(P<0.05).影像方面,与术前相比,术后6个月和末次随访时24例患者LCEA显著减少(P<0.05),而AI显著增加(P<0.05),交叉征、后壁征阳性比率显著下降(P<0.05).与术前相比,术后6个月、末次随访时T?nnis骨性关节炎分期和髋臼过深征阳性比率均无显著改变(P>0.05).[结论]髋关节镜下髋臼成形术治疗钳夹型股骨髋臼撞击征可以明显缓解患者的疼痛症状,改善髋关节功能,短期临床效果满意.[Objective]To explore the clinical outcomes of hip arthroscopy for mere pincer-type femoroacetabular impingement.[Methods]A retrospective study was conducted on a total of 24 patients who underwent hip arthroscopy for mere pincer-type femoroacetab-ular impingement in our department from June 2017 to July 2019.The patients included 14 females and 10 males,aged(33.52±11.42)years on average,and received arthroscopic acetabuloplasty for the pincer-type femoroacetabular impingement.[Results]All the patients were successfully operated on under arthroscope,and were confirmed to have pincer-type impingement only without femoral head-neck junction cam-like osteophytes.All patients got incisions healing primarily without complications such as intraarticular infection,necrosis of femoral head,deep vein embolism and nerve injury of lower limb.All the 24 patients were followed up for more than 12 months.The flexion,adduction and internal rotation(FADIR)test,as well as the flexion,abduction and external rotation(FABER)tests significantly improved in the 24 patients at 6 months postoperatively and at the last follow-up compared with those preoperatively(P<0.05).In addition,the VAS scores significantly decreased(P<0.05),while the mHHS and iHOT-12 scores significantly increased postoperatively compared with those before operation(P<0.05).Radiographically,the lateral center edge angle(LCEA)significantly reduced(P<0.05),the acetabular index(AI)increased significantly(P<0.05),whereas the positive rates of cross sign and posterior wall sign significantly decreased at 6 months postoperatively and at the latest follow-up compared with those preoperatively(P<0.05).However,there were no significant changes in terms of Tonnis osteoarthritis grades and the positive rate of deep acetabular sign at 6 months postoperatively,or at the last follow-up compared with that preoperatively(P>0.05).[Conclusion]Acetabuloplasty under hip arthroscopy does significantly relieve the pain,improve function and achieve sound short-term clinical outcomes for

关 键 词：股骨髋臼撞击征 钳夹型 髋关节镜 髋臼成形术 疗效 

分 类 号：R681.8[医药卫生—骨科学]