无会阴柱牵引下髋关节镜手术治疗股骨髋臼撞击征的短期疗效分析  

Short-term efficacy of hip arthroscopy in the treatment of femoroacetabular impingement syndrome without a perineal post traction

作　　者：李勇 李春宝[2] 孙景东 李彬彬 高秋明 陈瑞 刘洁 谢晶晶 邓宏 王耀霆 LI Yong;LI Chunbao;SUN Jingdong;LI Binbin;GAO Qiuming;CHEN Rui;LIU Jie;XIE Jingjing;DENG Hong;WANG Yaoting(Department of Orthopaedic,Taihe Hospital,Hubei University of Medicine,Shiyan 442000,Hubei,China;Department of Orthopaedic,the Fourth Medical Center,General Hospital of PLA,Beijing 100048,China)

机构地区：[1]十堰市太和医院(湖北医药学院附属医院)骨科,湖北十堰442000 [2]解放军总医院第四医学中心骨科医学部运动医学科,北京100048

出　　处：《中华骨与关节外科杂志》2024年第5期410-415,共6页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:探讨采用无会阴柱牵引下髋关节镜手术治疗股骨髋臼撞击综合征(FAI)的短期临床疗效。方法:回顾性分析2022年1月至2023年1月收治的20例FAI患者的临床资料。其中男11例,女9例,年龄25~62岁,平均(38.2±10.5)岁,所有患者均接受无会阴柱牵引下髋关节镜手术,包括髋臼成形术、缝合或清理损伤的盂唇,以及股骨头颈交界处凸轮骨赘磨削成形术。记录并比较术前及末次随访时患者髋关节屈髋活动度、α角、外侧中心边缘(LCE)角、疼痛视觉模拟评分(VAS)及改良Harris髋关节评分。结果:所有患者切口均一期愈合。术后1例患者出现足背麻木,给予营养神经等常规药物治疗1个月后症状消失。无患者出现会阴区血肿、大腿外侧麻木。所有患者均获得6~10个月随访,平均(8.04±1.21)个月。末次随访时,患者髋关节屈髋活动度及改良Harris髋关节评分高于术前,α角、LCE角及VAS评分低于术前,差异有统计学意义(P均<0.05)。结论:无会阴柱牵引下髋关节镜手术治疗FAI可以明显缓解患者的疼痛症状,改善髋关节功能,短期效果满意,可以有效避免髋关节镜术后会阴区并发症的发生。Objective:To explore short-term clinical effectiveness of hip arthroscopy in the treatment of FAI syndrome without a perineal post traction.Methods:A retrospective study was conducted on a total of 20 patients who underwent hip arthroscopy for femoroacetabular impingement in our department from January 2022 to January 2023.The patients included 11 females and 9 males,aged(38.24±10.46)years on average.Hip arthroscopic surgery without a perineal post traction was performed for all patients to received arthroscopic acetabuloplasty and to suture or clean the injured glenoid labrum.Arthroscopic osteoplasty was performed of the"cam-like"hyperplasia of the femoral head and neck.The range of hip motion,αangle,LCE angle,visual analogue scale(VAS)and modified Harris hip score were recorded before operation and at the final follow up.Results:The incision of all patients healed well.The numbness of dorsalis pedis region occurred in one patient after operation,the symptoms disappeared within one month after neurotrophic drug treatment.None of the patients occurred perineal region hematoma,lateral thigh numbness.The mean duration of follow-up was(8.04±1.21)months(range,6-10 months)in all the patients.At the last follow-up,the hip flexion range of motion and modified Harris hip score were higher than those before operation,while theαangle,LCE angle and VAS score were lower than those before operation,the difference was significant(all P<0.05).Conclusions:The hip arthroscopy without a perineal post traction.can significantly relieve symptoms,improve hip function and satisfactory short-term efficacy in patients with FAI,,and can effectively avoid the occurrence of perineal complications.

关 键 词：股骨髋臼撞击征 无会阴柱牵引 髋关节镜 

分 类 号：R687.4[医药卫生—骨科学]