髋关节旋转袖损伤关节镜修复手术的短期疗效  

Short-term effect of arthroscopy repair for hiprotator-cufftear

作　　者：尹翔宇 刘义 金权赫 刘文广[1] 殷庆丰[1] Yin Xiangyu;Liu Yi;Jin Quanhe;Liu Wenguang;Yin Qingfeng(Department of Joint Surgery/Sports Medicine,the Second Hospital of Shandong University,Jinan 250033,China)

机构地区：[1]山东大学第二医院关节外科/运动医学科,济南250033

出　　处：《中华骨科杂志》2023年第23期1593-1600,共8页Chinese Journal of Orthopaedics

摘　　要：目的探讨髋关节旋转袖损伤的临床特点、关节镜修复手术技术要点及短期临床疗效。方法回顾性分析2019年9月至2021年5月于山东大学第二医院行关节镜手术修复髋关节旋转袖损伤并获得2年以上随访的17例患者的病历资料,男6例、女11例,年龄56.0(49.5,62.5)岁(范围35~72岁)。其中9例(53%)存在夜间疼痛症状、10例(59%)屈髋内旋抗阻试验阳性。术前及术后1、3、6个月采用疼痛视觉模拟评分(visual analogue scale,VAS)评价疼痛改善情况。术前及术后6、12、24个月采用改良Harris髋关节评分(modified Harris hip score,mHHS)、国际髋关节功能评分(international hip outcome tool-12,iHOT-12)评估髋关节功能改善情况。结果所有患者均顺利完成手术,手术时间为(91.2±18.3)min(范围73~112 min),随访时间为29(25,33)个月(范围25~48个月)。术中探查所有患者均存在髋关节旋转袖撕裂,予以锚钉缝合修复。合并盂唇损伤10例,其中5例行盂唇修复。VAS评分由术前(5.24±1.15)分降低至术后1个月(2.29±0.69)分、3个月(1.77±0.56)分、6个月(1.59±0.62)分,差异有统计学意义(F=79.31,P<0.001);mHSS评分由术前(49.59±6.11)分提高至术后6个月(81.00±3.89)分、12个月(81.71±3.41)分、24个月(81.94±3.29)分,差异有统计学意义(F=232.00,P<0.001);iHOT-12评分由术前(42.65±6.04)分,提高至术后6个月(66.53±3.43)分、12个月(68.12±3.48)分、24个月(69.06±3.53)分,差异有统计学意义(F=150.00,P<0.001)。结论关节镜下手术修复是治疗髋关节旋转袖损伤的有效手段,短期临床疗效良好。ObjectiveTo investigate the clinical characteristics of hip rotator-cuff tear,arthroscopic repair techniques,and short-term clinical efficacy.MethodsA retrospective analysis was performed on the patient cohort from our department who underwent arthroscopic repair for hip rotator-cuff tears from September 2019 to May 2021,with a minimum follow-up duration of two years.The sample included 17 subjects,composed of 6 males and 11 females,with a median age of 56 years(interquartile range 49.5-62.5).Notably,9 patients(53%)reported nocturnal pain,and 10 patients(59%)exhibited a positive hip flexion resistance test.Patients'demographic details,clinical manifestations,radiographic findings,and intraoperative observations were analyzed.Pain amelioration was gauged by the visual analogue scale(VAS)at preoperative,1 month,3 months,and 6 months postoperative intervals.Enhancement in hip functionality was assessed by comparing the modified Harris hip score(mHHS),and the International hip outcome tool-12(iHOT-12)at preoperative,6 months,12 months,and 24 months postoperative junctures.ResultsAll interventions were successfully completed,with an average surgical duration of 91.2±18.3 minutes.The follow-up period averaged 29 months.Every patient presented with a hip rotator-cuff tear,which was corrected using anchor suturing.10 patients also had concomitant labrum injuries,with 5 cases undergoing labrum repair.The VAS score decreased from preoperative 5.24±1.15 to postoperative 2.29±0.69 at 1 month,1.77±0.56 at 3 months,and 1.59±0.62 at 6 months(F=79.31,P<0.001);The mHSS score increased from preoperative 49.59±6.11 to postoperative 81.00±3.89 at 6 months,81.71±3.41 at 12 months,and 81.94±3.29 at 24 months(F=232.00,P<0.001);The iHOT-12 score increased from preoperative 42.65±6.04 to postoperative 6 months 66.53±3.43,12 months 68.12±3.48,and 24 months 69.06±3.53(F=150.00,P<0.001).ConclusionDiagnosing hip rotator-cuff tears necessitates specific physical examinations complemented by high-definition magnetic resonance imag

关 键 词：髋关节 关节镜检查 治疗结果 旋转袖损伤 臀中肌 

分 类 号：R687.4[医药卫生—骨科学]