采用关节镜手术治疗运动员股骨髋臼撞击征的疗效与重返赛场情况  

Hip arthroscopy for femoroacetabular impingement in athletes:clinical outcomes and returning to sports after surgery

作　　者：高奉[1] 贺忱[1] 钱驿 果森 胥皞 郝悦 杨京伦 王雪松[2] 周敬滨[1] Gao Feng;He Chen;Qian Yi;Guo Sen;Xu Hao;Hao Yue;Yang Jinglun;Wang Xuesong;Zhou Jingbin(Department of Sports Injury and Arthroscopy Surgery, National Institute of Sports Medicine, Beijing 100061, China)

机构地区：[1]国家体育总局运动医学研究所体育医院运动创伤外科,北京100061 [2]北京积水潭医院运动医学科,100035

出　　处：《骨科临床与研究杂志》2022年第4期215-220,225,共7页Journal Of Clinical Orthopedics And Research

基　　金：国家重点研发计划科技冬奥专项(2018YFF0300604,2019YFF0301703)。

摘　　要：目的 探讨采用关节镜手术治疗中国运动员股骨髋臼撞击征(FAI)患者的疗效和术后患者重返赛场的情况。方法 对2017年1月至2021年3月国家体育总局运动医学研究所体育医院运动创伤外科采用关节镜手术治疗的运动员FAI患者15例的临床资料进行回顾性分析。其中男7例,女8例;手术年龄为(26.7±6.9)(19~33)岁。对患者术前与术后的髋关节α角、外侧中心边缘(LCE)角、改良Harris髋关节评分(mHHS)、髋关节日常运动能力量表(HOS-SSS)和疼痛视觉模拟评分(VAS)进行比较,并对患者重返赛场情况进行分析。结果 全部患者获得12个月以上随访。术前与末次随访VAS评分分别为(7.22±2.06)分和(1.58±0.78)分,mHHS评分分别为(61.13±10.27)分和(89.31±6.09)分,HOS-SSS评分分别为(40.38±13.06)分和(87.55±8.39)分,差异均有统计学意义(均P<0.001)。术前与术后LCE角分别为(35.81±6.12)°和(32.66±5.43)°,α角分别为(62.57±8.09)°和(47.13±5.96)°,术后均有显著减小(P=0.013,<0.001)。14例患者(93.3%)重返赛场,重返赛场时间为(7.6±4.5)个月。术前症状持续时间与重返赛场时间呈正相关(r=0.53;P=0.008);其中存在较严重软骨损伤的患者,术前症状持续时间显著长于无严重软骨损伤患者(P<0.001);健将级及以上运动员重返赛场时间较一级运动员短(P=0.027)。结论 采用关节镜手术治疗中国运动员FAI患者可获得令人满意的疗效,患者术后重返赛场概率较高。Objective To investigate the clinical outcomes of hip arthroscopic surgery for femoroacetabular impingement(FAI)in athletes and the probability of the patients returning to sports(RTS)after surgery.Methods A total of 15 athletes with FAI who met inclusion and exclusion criteria were retrospectively analyzed in Department of Sports Injury and Arthroscopy Surgery,National Institute of Sports Medicine from January 2017 and March 2021.There were 7 males and 8 females,with the mean age of(26.7±6.9)(19-33)years at the time of surgery.The clinical outcomes were evaluated by the alpha angle,lateral center-edge(LCE)angle,modified Harris Hip Score(mHHS),Hip Outcome Score-Sport-Specific Subscale(HOS-SSS)and Visual Analogue Scale(VAS)for pain before and after the surgery.The rate and times of return to sports(RTS)were analyzed.Results All patients were followed up for more than 12 months.The VAS score before surgery and at the last follow-up was(7.22±2.06)scores and(1.58±0.78)scores,the mHHS was(61.13±10.27)scores and(89.31±6.09)scores and the HOS-SSS was(40.38±13.06)scores and(87.55±8.39)scores.There was a significant improvement in the VAS,mHHS and HOS-SSS after surgery(P<0.05).The LCE angle before and after surgery was(35.81±6.12)°and(32.66±5.43)°,and the alpha angle was(62.57±8.09)°and(47.13±5.96)°,respectively.Both LCE angle and alpha angle were significantly decreased afere surgery(P<0.05).There were 14(93.3%)patients returning to sports,and the time of RTS was(7.6±4.5)months.The symptoms duration before the surgery was positively correlated with the time of RTS(r=0.53,P=0.008).Athletes with severe cartilage damage had longer symptom duration(P<0.001).Athletes with higher sports levels attained shorter time of RTS(P=0.027).Conclusion Satisfactory clinical outcomes and high rate of RTS could be achieved through hip arthroscopy for Chinese FAI athletes.

关 键 词：股骨髋臼撞击征 关节镜检查 运动员 治疗结果 重返赛场 

分 类 号：R687.4[医药卫生—骨科学]