关节囊优先切开髋关节镜技术治疗凸轮型股骨髋臼撞击综合征的疗效分析  

Efficacy analysis of hip arthroscopy with preferential capsulotomy in treatment of Cam-type femoroacetabular impingement syndrome

作　　者：张凯彬[1] 徐鸿尧 宋文锴 刘家林 ZHANG Kaibin;XU Hongyao;SONG Wenkai;LIU Jialin(Department of Sports and Joint,Nanjing First Hospital,Nanjing Medical University,Nanjing,Jiangsu 210012,China;不详)

机构地区：[1]南京医科大学附属南京医院运动关节科,江苏南京210012 [2]南京市雨花医院骨科,江苏210012

出　　处：《中国骨与关节损伤杂志》2024年第4期337-341,共5页Chinese Journal of Bone and Joint Injury

基　　金：南京市卫生科技发展专项基金项目(YKK22126,YKK20112)。

摘　　要：目的观察关节囊优先切开髋关节镜技术治疗凸轮型股骨髋臼撞击综合征的临床疗效。方法回顾性分析自2013-01—2021-01诊治的24例凸轮型股骨髋臼撞击综合征,所有患者采用关节囊优先切开髋关节镜技术治疗,比较术前与末次随访时疼痛VAS评分、改良髋关节功能Harris评分、屈髋活动度、屈髋90°内旋活动度、冠状位CT测量的α角。结果24例均获得随访,随访时间平均20.9(15~27)个月。12例术中探查发现合并关节软骨损伤。术后1例出现神经牵拉伤,表现为会阴部皮肤麻木,2周后自行消失。未出现医源性软骨或盂唇损伤、切口感染、骨折、动脉损伤、下肢深静脉血栓形成等并发症。末次随访时疼痛VAS评分、改良髋关节功能Harris评分、屈髋活动度、屈髋90°内旋活动度、冠状位CT测量的α角均较术前明显改善,差异有统计学意义(P<0.05)。结论采用关节囊优先切开髋关节镜技术治疗凸轮型股骨髋臼撞击综合征能够有效缓解患者疼痛症状,提高髋关节活动度,改善髋关节功能,具有手术创伤小、术后恢复快、并发症少等优点,临床疗效值得肯定。Objective To observe the clinical efficacy of hip arthroscopy with preferential capsulotomy in the treatment of Cam-type femoroacetabular impingement syndrome.Methods Twenty-four patients with Cam-type femoroacetabular impingement syndrome who underwent hip arthroscopic treatment with preferential capsulotomy from January 2013 to January 2021 were retrospectively analyzed.The VAS scores for pain,modified Harris scores for hip joint function,hip flexion range of motion,90°internal rotation range of motion,and alpha-angle on coronal CT images preoperatively and at the final follow-up were compared.Results All twenty-four patients completed the follow-up,with the mean follow-up time of 20.9(15 to 27)months.Twelve patients were found in operation with articular cartilage damage.One patient postoperatively developed nerve distraction showing numbness of perineal skin that resolved spontaneously after 2 weeks.No complications occurred,such as iatrogenic cartilage or labrum injury,incision infection,fracture,arterial injury,and deep vein thrombosis of the lower limbs.At the last follow-up,the VAS scores for pain,modified Harris scores for hip joint function,hip flexion range of motion,90°internal rotation range of motion,and alpha-angle on coronal CT images were all significantly improved compared with preoperative values.The difference was statistically significant(P<0.05).Conclusion Hip arthroscopy with preferential capsulotomy in the treatment of Cam-type femoroacetabular impingement syndrome can effectively relieve pain,improve range of motion and hip function of patients.It has the advantages of less surgical trauma,quick postoperative recovery and few complications.The clinical efficacy of this technique is reliable.

关 键 词：凸轮型股骨髋臼撞击综合征 关节镜 关节囊优先切开 软骨损伤 

分 类 号：R687.3[医药卫生—骨科学]