镜下两种关节囊切开凸轮型股骨髋臼撞击治疗的比较  

Comparison of two kinds of capsulotomy in hip arthroscopy for cam-type femoroacetabular impingement

作　　者：耿震 李春宝 安明扬 张柏青 刘玉杰 王明新 赵斌 王龙 王耀霆 GENG Zhen;LI Chun-bao;AN Ming-yang;ZHANG Bai-qing;LIU Yu-jie;WANG Ming-xin;ZHAO Bin;WANG Long;WANG Yao-ting(Department of Joint Surgery and Sports Medicine,The Third Shandong Provincial Hospital,Jinan 250031,China;Division of Sports Medicine,Department of Orthopedic Medicine,Fourth Medical Center,General Hospital of CP LA,Beijing 100853,China)

机构地区：[1]山东省立第三医院关节与运动医学科,山东济南250031 [2]中国人民解放军总医院第四医学中心骨科医学部运动医学科,北京100853

出　　处：《中国矫形外科杂志》2022年第5期405-409,共5页Orthopedic Journal of China

基　　金：国家重点研发计划项目(编号:2019YFE0126300)。

摘　　要：[目的]比较镜下T形关节囊切开与横形切开凸轮型股骨髋臼撞击治疗的临床疗效.[方法]回顾分析2017年7月-2018年6月关节镜手术治疗凸轮型髋关节撞击征的70例患者.其中,35例采用T形关节囊切开(T切组),另外35例采用横形关节囊切开(横切组).比较两组围手术期、随访与影像资料.[结果]两组患者均顺利手术,术中无重要血管、神经损伤等严重并发症.T切组的手术时间和术中透视次数均显著少于横切组(P<0.05).两组术中失血量、术后下地时间和住院时间的差异均无统计学意义(P>0.05).两组患者均随访24个月以上,平均(26.66±2.10)个月.与术前相比,末次随访时两组的VAS评分均显著下降(P<0.05),而mHHS和iHOT评分均显著增加(P<0.05).末次随访时,T切组的VAS评分小于横切组,但差异无统计学意义(P>0.05),但是,T切组的mHHS评分和iHOT-12评分均显著高于横切组(P<0.05).影像方面,与术前相比,末次随访时两组患者的α角和LCEA均显著减小(P<0.05),而FO显著增加(P<0.05).末次随访时,T切组在α角和FO显著优于横切组(P<0.05),但是两组间LCEA的差异无统计学意义(P>0.05).[结论]镜下T形关节囊切开治疗凸轮型股骨髋臼撞击综合征的临床效果明显优于关节囊横形切开.[Objective]To compare the clinical efficacy of T-shaped capsulotomy versus transverse capsulotomy in hip arthroscopy for treatment of the cam-type femoroacetabular impingement syndrome(FAI).[Methods]A retrospective study was done on 70 patients who underwent arthroscopic surgery for cam-type FAI from July 2017 to June 2018.Among them,35 patients had the capsule opened by T-shaped incision(the T-shaped group),while the remaining 35 patients received transverse capsulotomy(the transverse group).The perioperative,follow-up and imaging documents were compared between the two groups.[Results]All patients in both groups had operation performed successfully without serious complications,such as injuries to important blood vessel and nerve.The T-shaped group proved significantly superior to the transverse group in terms of operation time and intraoperative fluoroscopy frequency(P<0.05),although there were no significant differences in total incision length,intraoperative blood loss,time to recover ambulation and hospital stay between the two groups(P>0.05).All patients in both groups were followed up for more than 24 months,with an average of(26.66±2.10)months.The VAS scores significantly decreased(P<0.05),whereas the mHHS and iHOT scores significantly increased in both groups at the latest follow up compared with those preoperatively(P<0.05).The T-shaped group had lower VAS score than the transverse group at the latest follow up,but the difference was not statistically significant(P>0.05).However,the T-shaped group had significantly higher mHHS and iHOT-12 scores than the transverse group at the latest follow up(P<0.05).Radiographically,the a angle and lateral center edge angle(LCEA)significantly reduced(P<0.05),while the femoral head-neck offset(FHNO)significantly increased in both groups at the latest follow-up compared with those preoperatively(P<0.05).The T-shaped group proved significantly superior to the transverse group in terms of a angle and FHNO at the last follow-up(P<0.05),nevertheless,there was no a signif

关 键 词：股骨髋臼撞击症 凸轮型 髋关节镜术 关节囊切开 

分 类 号：R681.8[医药卫生—骨科学]