关节囊缝合对股骨髋臼撞击征关节镜手术临床疗效的影响  

Clinical Efficacy of Joint Capsule Suture in Arthroscopic Surgery of Femomacetabular Impingement

作　　者：杨伟铭 曹学伟 田铁桥 赵彩琼 林定坤 Yang Weiming;Cao Xuewei;Tian Tieqiao;Zhao Caiqiong;Lin Dingkun(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东省中医院骨关节科,广东广州510120

出　　处：《实用骨科杂志》2022年第8期686-690,共5页Journal of Practical Orthopaedics

基　　金：2020年度广东省高等教育教学改革项目(粤教高函[2020]20号);2021年度广州民政科技基金(2021MZK33)。

摘　　要：目的探讨关节囊缝合对股骨髋臼撞击症(femoralacetabular impingement,FAI)关节镜手术临床疗效的影响。方法回顾性分析2019年6月至2020年12月在广东省中医院诊断为合并髋臼盂唇损伤的股骨髋臼撞击征患者并行髋关节镜治疗的患者共62例,按是否缝合关节囊分为缝合组及未缝合组;缝合组32例,其中男15例,女17例;平均年龄(36.3±8.9)岁。未缝合组30例,其中男14例,女16例,平均年龄(37.8±6.2)岁。所有患者均在全麻下行髋关节镜检查盂唇修复及股骨成型术;缝合组采用鞋带法缝合关节囊,未缝合组不对关节囊进行缝合。选择改良Harris髋关节评分(modified Harris hip score,mHHS)、日常活动髋关节功能评分(hip outcome score activities of daily living,HOS-ADL)、体育运动专用髋关节评分(hip outcome score sports specific subscale,HOS-SSS),评价临床疗效。术后半年时复查髋关节MRI,评价关节囊愈合情况。结果两组手术均顺利完成,缝合组手术时间显著长于非缝合组(P<0.05),但两组在住院时间上差异无统计学意义(P>0.05);围手术期内均无严重并发症发生。所有患者均获随访,随访时间9~12个月,平均(10.2±5.3)个月。两组患者术前HOS-ADL评分、HOS-SSS评分、mHHS评分差异无统计学意义(P>0.05)。两组患者术后6个月随访时HOS-ADL评分、HOS-SSS评分、mHHS评分均较术前显著提高(P<0.001)。术后6个月随访时缝合组的HOS-ADL评分、HOS-SSS评分、mHHS评分均较未缝合组高(P<0.05)。结论采用鞋带法连续缝合关节囊有助于提高FAI髋关节镜手术患者的临床疗效,且不增加手术并发症。Objective To assess the effect of suturing the joint capsule in arthroscopic surgery for femoralacetabular impingement(FAI).Methods A total of 62 patients diagnosed with FAI and treated with hip arthroscopy in Guangdong Provincial Hospital of Chinese Medicine from June 2019 to December 2020 were retrospectively analyzed.All patients underwent hip arthroscopy,labrum repair and femur plasty.According to whether the joint capsule was sutured in the operation or not,patients were divided into sutured group(n=32)and unsutured group(n=30).There were 15 males and 17 females,with an average age of(36.3±8.9)in sutured group.There were 14 males and 16 females,with an average age of(37.8±6.2)in unsutured group.Shoelace method was applied to suture joint capsule in the sutured group,while the joint capsule was left unsutured in the other group.All patients were assessed by the modified Harris hip score(mHHS),hip outcome score sports specific subscale(HOS-SSS),hip outcome score-activities of daily living(HOS-ADL).MRI was performed six months after the operation to evaluate the capsular condition.Results The operations in both groups were successfully completed.The operation time of sutured group was significantly longer than that of unsutured group(P<0.05),but there was no significant difference in day of hospitalization between the two groups(P>0.05).No serious complications occurred.All patients were followed up for 9~12 months,with a mean follow-up of(10.2±5.3)months.Preoperative HOS-ADL score,HOS-SSS score,mHHS score had no significant difference between the two groups(P>0.05).HOS-ADL score,HOS-SSS score,mHHS score were significantly increased in both groups at 6 months(P<0.001).HOS-ADL score,HOS-SSS score,mHHS score of the sutured group were higher than those of the unsutured group at the 6-month follow-up(P<0.05).Conclusion Suturing the joint capsule with shoelace method in arthroscopic hip surgery can improve the clinical outcome of FAI arthroscopic hip surgery,without increasing risk of complications.

关 键 词：髋关节 关节镜 盂唇损伤 股骨髋臼撞击 关节囊 

分 类 号：R684[医药卫生—骨科学]