关节镜下经转子周围间室由内向外松解术治疗外侧型弹响髋  

Arthroscopic release through the peritrochanteric compartment from inside-out in the treatment of lateral snapping hip

作　　者：郭旗 王续鹏 李明[1] 梁振雷[1] 刘宁[1] Guo Qi;Wang Xupeng;Li Ming;Liang Zhenlei;Liu Ning(Department of Sports Medicine,Zhengzhou Orthopaedics Hospital Affiliated to Henan University,Zhengzhou 450052,China)

机构地区：[1]河南大学附属郑州市骨科医院运动医学科,郑州450052

出　　处：《中华骨科杂志》2023年第23期1573-1579,共7页Chinese Journal of Orthopaedics

摘　　要：目的探讨关节镜下经转子周围间室由内向外松解术治疗外侧型弹响髋的临床疗效。方法回顾性分析2016年12月至2022年12月于河南大学附属郑州市骨科医院运动医学科接受关节镜手术治疗的外侧型弹响髋患者38例(70髋),男13例、女25例,年龄(27.8±7.6)岁(范围15~45岁);其中单侧6例、双侧32例。根据松解术路径的不同分为由外向内组(37髋)和由内向外组(33髋)。采用视觉模拟评分(visual analogue scale,VAS)评估术后髋关节疼痛,臀肌挛缩症功能量表(gluteal muscle contracture disability scale,GDS)评价术后疗效,改良Harris髋关节评分(modified Harris hip score,mHHS)评分评估术后髋关节功能。结果两组患者均顺利完成手术并获得随访,随访时间为(8.23±1.25)个月(范围6~12.8个月)。由内向外组术前、术后1周、术后3个月的髋关节VAS评分分别为[4.0(3.5,6.0)]分、[5.0(4.0,6.0))]分、[1.0(0.5,1.0)]分,由外向内组分别为[4.0(3.5,6.0)]分、[5.0(4.0,6.0)]分、[1.0(0.5,1.0)]分,两组患者手术前后髋关节VAS组内比较的差异均有统计学意义(P<0.05),术后3个月的髋关节VAS均小于术前和术后1周,差异有统计学意义(P<0.05)。不同时间点组间比较的差异无统计学意义(P>0.05)。由内向外组术前、术后1周、术后3个月的GDS评分分别为(52.30±8.19)分、(75.03±6.41)分、(92.30±4.61),由外向内组分别为(51.97±6.64)分、(75.41±7.10)分、(91.32±4.18)分,两组患者手术前后髋关节GDS功能量化评分组内比较的差异均有统计学意义(P<0.05),术后3个月的髋关节GDS功能量化评分均大于术前和术后1周,差异有统计学意义(P<0.05)。不同时间点组间比较的差异无统计学意义(P>0.05)。两组患者手术前后mHHS组内比较的差异均有统计学意义(P<0.05),术后3个月的mHHS均大于术前和术后1周,差异有统计学意义(P<0.05)。由内向外组术后1周的mHHS为(79.03±7.37)分,大于由外向内组的(71.32±10.02)分,差异�ObjectiveTo investigate the clinical effect of arthroscopic release through the peritrochanteric compartment from inside-out in the treatment of lateral snapping hip.MethodsA total of 38 patients(70 hips)with lateral snapping hip who underwent arthroscopic surgery in Department of Sports Medicine,Zhengzhou Orthopaedics Hospital Affiliated to Henan University from December 2016 to December 2022 were retrospectively analyzed.There were 13 males and 25 females,aged 27.8±7.6 years(range,15-45 years).Among them 6 cases of unilateral and bilateral 32 cases.According to the different release approaches,they were divided into outside-in group(37 hips)and inside-out group(33 hips).Visual analogue scale(VAS)was used to evaluate postoperative hip pain,and gluteal muscle contracture disability scale(GDS)was used to evaluate postoperative effectiveness.Postoperative hip function was evaluated by modified Harris hip score(mHHS).ResultsAll patients in the two groups successfully completed the operation and were followed up for 8.23±1.25 months(range,6-12.8 months).The hip VAS scores in the inside-out group were 4.0(3.5,6.0),5.0(4.0,6.0),and 1.0(0.5,1.0)before surgery,1 week after surgery,and 3 months after surgery,respectively,and those in the outside-in group were 4.0(3.5,6.0),5.0(4.0,6.0),and 1.0(0.5.1.0),and the differences between the two groups of patients in the within group comparison of hip VAS before and after surgery were statistically significant(P<0.05).The hip VAS at 3 months postoperatively was smaller than that before surgery and at 1 week postoperatively,and the differences were statistically significant(P<0.05).There were no significant differences between groups at different time points(P>0.05).The GDS scores in the inside-out group were 52.30±8.19,75.03±6.41,and 92.30±4.61 preoperatively,1 week postoperatively,and 3 months postoperatively,respectively,and in the outside-in group were 51.97±6.64,75.41±7.10,and 91.32±4.18,respectively,and the differences in the quantitative GDS function scores of the hi

关 键 词：髋关节 关节镜检查 肌筋膜松解疗法 

分 类 号：R687.4[医药卫生—骨科学]