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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Arthroscopic Treatment of Acetabular Retroversion With Acetabuloplasty and Subspine Decompression: A Matched Comparison With Patients Undergoing Arthroscopic Treatment for Focal Pincer-Type Femoroacetabular Impingement
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Arthroscopic Treatment of Acetabular Retroversion With Acetabuloplasty and Subspine Decompression: A Matched Comparison With Patients Undergoing Arthroscopic Treatment for Focal Pincer-Type Femoroacetabular Impingement

机译：关节镜下手法治疗髋臼逆行并进行髋臼减压术：与接受关节镜治疗局灶性钳型股骨髋臼撞击的患者相匹配

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Background: Global acetabular retroversion is classically treated with open reverse periacetabular osteotomy. Given the low morbidity and recent success associated with the arthroscopic treatment of femoroacetabular impingement (FAI), there may also be a role for arthroscopic treatment of acetabular retroversion. However, the safety and outcomes after hip arthroscopic surgery for retroversion need further study, and the effect of impingement from the anterior inferior iliac spine (subspine) in patients with retroversion is currently unknown. Hypothesis: Arthroscopic treatment for global acetabular retroversion will be safe, and patients will have similar outcomes compared with a matched group undergoing arthroscopic treatment for focal pincer-type FAI. Study Design: Cohort study; Level of evidence, 2. Methods: Patients undergoing hip arthroscopic surgery for symptomatic global acetabular retroversion were prospectively enrolled and compared with a matched group of patients undergoing arthroscopic surgery for focal pincer-type FAI. Both groups underwent the same arthroscopic treatment protocol. All patients were administered patient-reported outcome (PRO) measures, including the 12-item Short-Form Health Survey (SF-12) Physical Component Summary (PCS) and a Mental Component Summary (MCS), modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and visual analog scale (VAS) for pain preoperatively and at 1 year postoperatively. Results: There were no differences in age, sex, or body mass index between 39 hips treated for global acetabular retroversion and 39 hips treated for focal pincer-type FAI. There were no major or minor complications in either group. Patients who underwent arthroscopic treatment for global acetabular retroversion demonstrated similar significant improvements in postoperative PRO scores (scores increased by 17 to 43 points) as patients who underwent arthroscopic treatment for focal pincer-type FAI. Patients treated for retroversion who also underwent subspine decompression had greater improvement than patients who did not undergo subspine decompression for the HOOS-Pain (33.7 ± 15.3 vs 22.5 ± 17.6, respectively; P = .046) and HOOS–Quality of Life (49.7 ± 18.8 vs 34.6 ± 22.0, respectively; P = .030) scores. Conclusion: Arthroscopic treatment for acetabular retroversion is safe and provides significant clinical improvement similar to arthroscopic treatment for pincer-type FAI. Patients with acetabular retroversion who also underwent arthroscopic subspine decompression demonstrated greater improvements in pain and quality of life outcomes than those who underwent arthroscopic treatment without subspine decompression.
机译：背景：髋臼逆行手术通常采用开放式反向髋臼周围截骨术治疗。鉴于关节镜治疗股骨髋臼撞击（FAI）的发病率较低且最近取得了成功，关节镜治疗髋臼逆行也可能发挥作用。然而，髋关节镜手术进行逆行手术的安全性和结局尚需进一步研究，逆行患者的前下（骨（亚脊柱）撞击的影响目前尚不清楚。假设：关节镜治疗髋臼逆行是安全的，与接受关节镜治疗局灶性钳形FAI的配对组相比，患者的结局相似。研究设计：队列研究;证据等级：2。方法：前瞻性纳入接受髋关节镜手术以应对有症状的全髋臼倒退的患者，并与接受关节镜手术的局灶性钳式FAI患者进行比较。两组均接受相同的关节镜治疗方案。所有患者均接受了患者报告的结局（PRO）措施，包括12项简短形式健康调查（SF-12）身体成分摘要（PCS）和心理成分摘要（MCS），以及经过修改的Harris髋关节评分（mHHS） ，术前和术后1年的疼痛程度，髋关节残疾和骨关节炎结果评分（HOOS）和视觉模拟量表（VAS）。结果：接受全髋臼逆行治疗的39髋与经局部钳形FAI治疗的39髋之间，年龄，性别或体重指数无差异。两组均无重大并发症。接受关节镜治疗整体髋臼逆行的患者与接受关节镜治疗局灶性钳形FAI的患者相比，术后PRO得分有显着改善（得分提高了17至43分）。接受过逆行治疗且还进行了脊柱减压的患者比未经历过脊柱减压的患者的HOOS疼痛（分别为33.7±15.3 vs 22.5±17.6; P = .046）和HOOS-生活质量（49.7±分别为18.8和34.6±22.0; P = .030）得分。结论：关节镜治疗髋臼逆行是安全的，与钳形FAI关节镜治疗相似，可提供重大的临床改善。髋臼逆行患者也接受了关节镜下减压治疗，与未接受膝关节减压治疗的患者相比，疼痛和生活质量的改善更大。

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