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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Does Relief from Intra-articular Anesthetic Injection Predict Outcome after Hip Arthroscopy?
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Does Relief from Intra-articular Anesthetic Injection Predict Outcome after Hip Arthroscopy?

机译：髋关节镜检查后关节内麻醉注射的缓解是否可以预测结果？

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Objectives: Arthroscopy is being used more frequently as a treatment for intra-articular hip pathology due to femoroacetabular impingement (FAI). Prior to surgery, intra-articular anesthetic injection is commonly performed as a diagnostic test to localize the source of pain. Currently, there is a paucity of data correlating post-injection pain relief and functional outcomes after hip arthroscopy for FAI. The purpose of this study is to determine whether the amount of pain relief after preoperative intra-articular anesthetic injection predicts clinical and functional outcomes following hip arthroscopy with minimum one year follow-up. We hypothesize that increased pain relief (>50%) will correlate with better outcomes after surgery. Methods: The records of patients undergoing hip arthroscopy for FAI at our institution between April 2007 and April 2012 were reviewed. We identified patients who underwent pre-operative intra-articular anesthetic injection and subsequent hip arthroscopy. Inclusion criteria were: ultrasound or fluoroscopic guided intra-articular anesthetic injection performed at our institution, documented pre- and post-injection Numerical Rating Scale (NRS) pain scores, no prior ipsilateral hip surgery, and minimum 1 year follow-up. Pre-operative radiographs were reviewed and degree of osteoarthritis was determined using the Tonnis classification system. Outcomes were assessed with Modified Harris Hip Score (MHHS) and Hip Outcome Score (HOS). Univariate and multivariate models were performed to assess whether percent pain relief correlated with outcome scores. Results: 57 hips in 55 patients met our inclusion criteria and included 37 females (67%) and 18 males (33%) with a mean age of 42.6 ± 14.7 (range 15-68) years. 8 patients had Tonnis grade 0, 35 had Tonnis grade 1, and 14 had Tonnis grade 2. Mean pain relief after intra-articular injection was 74.4 ± 31.9 (range 0-100) percent. 13 patients (23%) had ≤50% pain relief while 44 (77%) had >50% pain relief. Outcome scores were obtained at a mean 25.5 (range 12- 60) months. Mean MHHS, HOS-ADL, and HOS-Sport scores were 82.1 ± 17.4 (range 42.9-100), 85.0 ± 16.6 (range 39.7-100), and 71.8 ± 28.1 (range 11.1-100) respectively. There was no correlation between percent pain relief and MHHS, HOS-ADL, or HOS-Sport scores. There was no significant difference in outcome scores between those with ≤50% and >50% pain relief. When adjusting for Tonnis grade there was no correlation between percent relief and any of the outcome scores measured. Conclusion: In patients undergoing hip arthroscopy for FAI, our data indicates that the amount of pain relief from intra-articular anesthetic injection does not correlate with minimum 1 year clinical and functional outcomes even when adjusting for Tonnis grade. Although pain relief did not predict outcomes in our study, we still believe it is a useful diagnostic tool to localize the source of pain in patients considering hip arthroscopy.
机译：目的：由于股骨髋臼撞击（FAI），关节镜检查被更常用于关节内髋关节病变的治疗。手术前，通常进行关节内麻醉注射作为诊断测试，以定位疼痛的来源。目前，在髋关节镜下进行FAI时，缺乏与注射后止痛和功能结局相关的数据。这项研究的目的是确定术前关节内麻醉注射后缓解疼痛的量是否可以预测髋关节镜检查后至少一年的随访的临床和功能结果。我们假设增加的疼痛缓解（> 50％）将与术后更好的预后相关。方法：回顾性分析了2007年4月至2012年4月在我院接受髋关节镜检查的FAI患者的病历。我们确定了接受术前关节内麻醉注射和随后的髋关节镜检查的患者。纳入标准为：在我们机构进行超声或荧光透视引导下的关节内麻醉注射，有记录的注射前和注射后数字评分表（NRS）疼痛评分，未进行过同侧髋关节手术以及至少1年的随访。回顾术前X线照片，并使用Tonnis分类系统确定骨关节炎的程度。结果以改良的Harris髋关节得分（MHHS）和髋关节得分（HOS）进行评估。进行单变量和多变量模型以评估疼痛缓解百分比是否与预后评分相关。结果：55名患者中的57髋符合我们的纳入标准，其中37名女性（67％）和18名男性（33％）平均年龄为42.6±14.7（15-68岁）。 Tonnis等级为0的8例患者，Tonnis等级为2的35例，Tonnis等级2的14例。平均关节内注射后疼痛缓解率为74.4±31.9（范围0-100）。 13例患者（23％）的疼痛缓解率≤50％，而44例患者（77％）的疼痛缓解率大于50％。在平均25.5（12-60）个月时获得结果评分。 MHHS，HOS-ADL和HOS-Sport的平均得分分别为82.1±17.4（范围42.9-100），85.0±16.6（范围39.7-100）和71.8±28.1（范围11.1-100）。缓解疼痛的百分比与MHHS，HOS-ADL或HOS-Sport评分之间没有相关性。疼痛缓解率≤50％和> 50％的患者在结果评分上无显着差异。在调整Tonnis评分时，缓解百分率与所测得的任何结果得分之间都没有相关性。结论：在接受髋关节镜检查进行FAI的患者中，我们的数据表明，即使调整Tonnis分级，关节内麻醉注射减轻的疼痛程度与至少1年的临床和功能结局也不相关。尽管疼痛缓解并未在我们的研究中预测结果，但我们仍然相信它是一种有用的诊断工具，可用于确定考虑进行髋关节镜检查的患者的疼痛源。

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