目的:探讨股骨髋臼撞击(femoro-acetabular impingement，FAI)综合征患者髋关节镜术后并发髋关节炎(hip osteoarthritis，HOA)的危险因素，减少和预防HOA的发生。方法:自2018年9月至2020年9月采用髋关节镜手术治疗106例FAI患者，男40例，女66例;年龄20～55(33。05±10。19)岁;运动伤51例，交通事故伤36例，钝物砸伤19例;病程5～19(12。02±3。69)d。术后随访18个月，根据是否发生HOA将患者分为HOA组23例和无HOA组83例。采用多元Logistic回归分析影响FAI患者髋关节镜术后并发HOA的危险因素。结果:经单因素分析，HOA组年龄50～70岁、女性、身体质量指数＞30 kg·m-2、体力劳动、凸轮型、术后并发感染、术后末次随访髋关节关节活动度(range of motion，ROM)及Tönnis分级1级及以上比例均高于无HOA组(P＜0。05)，相对骨骼肌指数(relative appendicular skeletal muscle index，RASM)低于无HOA组(P＜0。05)。多元Logistic回归分析结果显示，凸轮型、身体质量指数＞30kg·m-2、术后末次随访髋关节内旋ROM及Tönnis分级≥1级是FAI患者髋关节镜术后发生HOA的危险因素(P＜0。05)。结论:FAI分型、身体质量指数、髋部ROM、Tönnis分级均与FAI患者髋关节镜术后并发HOA有关，对高危FAI患者应加强随访和干预，以减少HOA的发生。
Risk factors for hip osteoarthritis after arthroscopy in patients with femoroacetabular impingement
Objective To investigate the risk factors of hip osteoarthritis(HOA)after hip arthroscopy in patients with femoro-acetabular impingement(FAI)syndrome,and to reduce and prevent HOA.Methods From September 2018 to Septem-ber 2020,106 patients with FAI underwent hip arthroscopy,including 40 males and 66 females,aged from 20 to 55 years old with an average age of(33.05±10.19)years old.The mechanism of injury included 51 cases for sports injury,36 for traffic ac-cidents,and 19 for blunt object injury.The duration of the disease ranged from 5 to 19 days with an average of(12.02±3.69)days.All patients were followed up for 18 months.Patients were divided into HOA group(23 cases)and non-HOA group(83 cases)according to the occurrence of HOA.Multivariate Logistic regression was used to analyze the risk factors of HOA after hip arthroscopy in FAI patients.Results By univariate analysis,aged from 50 to 70 years old,female,body mass index(BMI)＞30 kg·m-2,physical labor,cam type,postoperative infection,last follow-up hip degree of motion(range of motion,ROM)(flex-ion,abduction,adduction,internal rotation)and Tönnis grade 1 and above of the HOA group were higher than those of the non-HOA group(P＜0.05),and the relative appendicular skeletal muscle index(RASM)was lower than that of non-HOA group(P＜0.05).By multiple Logistic regression analysis,cam type,BMI＞30 kg·m-2,last follow-up hip internal rotation ROM and Tönnis grade 1 were risk factors for HOA after hip arthroscopy in FAI patients(P＜0.05).Conclusion FAI classification,body mass index,hip ROM and Tönnis grade are all related to HOA after hip arthroscopy in FAI patients.Follow-up and intervention should be strengthened in high-risk FAI patients to reduce the occurrence of HOA.
万方数据
维普
