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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Relationship Between Age at Onset of Symptoms and Intraoperative Findings in Hip Arthroscopic Surgery
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Relationship Between Age at Onset of Symptoms and Intraoperative Findings in Hip Arthroscopic Surgery

机译：髋关节镜手术中症状和术中发现的年龄的关系

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Background:Hip arthroscopic surgery is intended to treat multiple abnormalities in an effort to delay the progression to osteoarthritis, especially in young patients. However, the length of time in which patients experience joint pain before seeking a specialist for a diagnosis can delay hip preservation surgery and influence clinical outcomes.Purpose:To investigate the relationship between age at symptom onset and findings during hip arthroscopic surgery as well as outcomes after 2 years of clinical follow-up.Study Design:Cohort study; Level of evidence, 3.Methods:From February 2008 to March 2015, data were prospectively collected on all patients undergoing hip arthroscopic surgery at a single institution. Anatomic and pathological characteristics were recorded intraoperatively. The mean age at onset of symptoms was calculated and correlated with intraoperative findings using Pearson correlation and logistic regression. All patients were assessed preoperatively and postoperatively with 4 patient-reported outcome measures: the modified Harris Hip Score (mHHS), the Non-Arthritic Hip Score (NAHS), the Hip Outcome Score–Activities of Daily Living (HOS-ADL), and the Hip Outcome Score–Sport-Specific Subscale (HOS-SSS). Pain was estimated using a visual analog scale (VAS). Furthermore, patients with an age at onset of symptoms below the mean (34.6 years) were compared with those of an age at onset of symptoms above the mean. The 2 groups were compared using the Student t test and the chi-square test. P values <.05 were considered significant.Results:A total of 1697 patients met the inclusion criteria. Body mass index was weakly correlated with age (r = 0.3). Younger patients had a lower prevalence of combined Seldes type 1 and 2 labral tears; acetabular labrum articular disruption (ALAD) grade 2, 3, and 4 acetabular chondral lesions; and Outerbridge grade 2, 3, and 4 femoral head chondral lesions (P < .05 for all). More advanced age was correlated with wider labral tears and chondral lesions based on a clock face (r ≥ 0.2, P < .05). Patients younger than 34.6 years had a lower prevalence of gluteus medius and ligamentum teres tears (P ≤ .001). The prevalence of synovitis was positively correlated with age, while instability was negatively correlated with age (P = .04). The improvement of scores from preoperatively to 2-year follow-up in the younger patient group was 62.69 to 83.82 for the mHHS, 64.97 to 87.35 for the HOS-ADL, 43.46 to 73.37 for the HOS-SSS, 63.01 to 85.19 for the NAHS, and 5.61 to 2.53 for pain VAS. All score improvements were statistically significant (P < .001). Regarding the older patient group, the improvement of scores from preoperatively to 2-year follow-up was 58.55 to 78.27 for the mHHS, 57.59 to 79.66 for the HOS-ADL, 35.63 to 61.88 for the HOS-SSS, 55.28 to 77.55 for the NAHS, and 5.72 to 3.01 for pain VAS. All score improvements were statistically significant (P < .001).Conclusion:Of the multiple intraoperative findings in hip arthroscopic surgery, many are related to age at onset of symptoms. Although we found a statistically significant improvement in clinical outcomes in both groups after 2-year follow-up, apparently the less complex and smaller lesions observed in both the articular cartilage and the labrum of younger patients result in better outcomes compared with older patients.
机译：背景：髋关节镜手术旨在治疗多种异常，以促进对骨关节炎的进展，特别是在年轻患者中。然而，患者在寻求诊断专家之前经历关节疼痛的时间长度可以推迟髋关节保存手术和影响临床结果。探讨症状发作期间的年龄与髋关节镜手术治疗的关系以及结果经过2年的临床关门.study设计：队列研究; 3.方法：方法：从2008年2月至2015年3月，所有在一个机构接受髋关节关节镜手术的患者预期收集数据。术中记录了解剖学和病理特征。症状发作的平均年龄与使用Pearson相关性和逻辑回归的术中发现相关。所有患者术前和术后评估了4例患者报告的结果措施：修饰的哈里斯髋关节评分（MHHS），非关节炎阶段评分（NAH），日常生活（HOS-ADL）的髋关节结果评分 - 活动和髋关节结果评分 - 特定于体育的子级（HOS-SSS）。使用视觉模拟量表（VAS）估计疼痛。此外，与症状症状的年龄低于平均值（34.6岁）的患者与症状上方的症状发作的年龄均进行比较。使用学生T测试和Chi-Square测试进行比较2组。 P值<.05被认为是显着的。结果：共有1697名患者达到纳入标准。体重指数与年龄弱相关（r = 0.3）。较年轻的患者的患病率较低，合并的Seldes型1和2型患者;髋臼唇关节破坏（ALAD）2,3和4级髋臼骨质病变;和外桥级2,3和4个股骨头骨性病变（全部P <.05）。基于时钟面（R≥0.2，P <0.05），更高龄的年龄与较宽的唇泪和肺部病变相关联。小于34.6岁的患者具有较低的臀肌和韧带撕裂的患病率较低（P≤.001）。滑膜炎的患病率与年龄呈正相关，而不稳定与年龄呈负相关（P = .04）。对于HHHS，64.97至87.35，HOS-SSS，63.01至85.19，64.97至87.35，为63.46至73.37，为62.97至87.35，持续时间为2年的分数为62.69至83.82。和5.61至2.53疼痛VAS。所有评分改进都有统计学意义（P <.001）。关于较旧的患者组，MHHS的术前到2年后续的分数为58.55至78.27，适用于HOS-ADL的57.59至79.66〜79.66，适用于HOS-SSS，55.63至61.88，55.28至77.55 Nahs，5.72至3.01疼痛VAS。所有成绩改善都有统计学意义（P <.001）。结论：髋关节镜手术中的多个术中发现，许多与症状发作的年龄有关。虽然我们在两年后发现两组临床结果的统计学意义，显然，与老年患者相比，患者的关节软骨和较年轻患者的唇部观察到的复杂性和更小的病变。

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