钳夹型髋撞击症无透视与透视下髋臼成形术比较
Comparison of non-fluoroscopy and fluoroscopy acetabuloplasty for pincer femoroacetabular impingement
于康康 1吴毅东 1李中耀 1甘露 1安明扬 1王明新 1王龙 1王耀霆 1张立宁 2常祺 3李春宝1
作者信息
- 1. 解放军总医院第四医学中心骨科医学部,北京 100853
- 2. 解放军总医院第一医学中心康复医学科,北京 100853
- 3. 中国人民解放军联勤保障部队第989医院全军军事训练医学研究所,河南洛阳 471031
- 折叠
摘要
[目的]比较无透视髋臼"一字成形"与目前常规术中透视髋臼成形术治疗钳夹型髋关节撞击综合征的临床效果.[方法]回顾性分析2021年10月-2023年2月在解放军总医院骨科采用髋关节镜术治疗的70例钳夹型髋撞击综合征患者的临床资料.根据医患沟通结果,35例在无透视下行髋臼一字成形术(无透视组);另外35例常规在透视下行髋臼成形术.比较两组围手术期、随访和影像资料.[结果]两组患者均顺利手术,术中无重要血管、神经损伤等严重并发症.无透视组在手术时间[(110.1±14.8)min vs(128.5±22.5)min,P＜0.001]和术中透视次数[(0.9±0.9)次 vs(2.9±1.4)次,P＜0.001]均显著优于透视组.两组术中失血量、切口愈合和住院时间的差异均无统计学意义(P＞0.05).两组患者均获随访12个月以上,平均(26.4±5.5)个月.与术前相比,末次随访时两组的VAS评分均显著减少(P＜0.05),而mHHS和iHOT评分均显著增加(P＜0.05).术前两组间VAS、mHHS和iHOT评分的差异均无统计学意义(P＞0.05);末次随访时,透视组的VAS评分、mHHS评分小于无透视组,iHOT-12评分高于无透视组,但两组间差异均无统计学意义(P＞0.05).影像方面,与术前相比,末次随访时,两组患者的外侧中心-边缘角(lateral center-edge angle,LCEA)和髋臼指数(acetabular index,AI)均较术前显著改善(P＜0.05),相应时间点,两组间LCEA和AI的差异均无统计学意义(P＞0.05).[结论]关节镜下无透视与常规透视髋臼成形术均能获得良好的临床效果,两种方法的临床效果无明显差异,但前者能节省手术时间并减少辐射对健康的影响.
Abstract
[Objective]To compare the clinical effect of non-fluoroscopy(NFS)arthroscopic acetabuloplasty versus conventional fluo-roscopy(FS)counterpart for treatment of pincer femoroacetabular impingement(P-FAI).[Methods]A retrospective analysis was performed on 70 patients who were underwent hip arthroscopy for P-FAI in Department of Orthopedics,PLA General Hospital from October 2021 to February 2023.According to the preoperative doctor-patient communication,35 patients underwent a line-like acetabuloplasty under NFS arthroscopy,while other 35 patients underwent conventional FS arthroscopic acetabuloplasty.The documents regarding to perioperative peri-od,follow-up and images were compared between the two groups.[Results]All patients in both groups had the arthroscopic procedure per-formed successfully without serious complications,such as injury of important blood vessels and nerves.The NFS group proved significantly superior to the FS group in terms of operative time[(110.1±14.8)min vs(128.5±22.5)min,P＜0.001]and intraoperative fluoroscopy times[(0.9±0.9)times vs(2.9±1.4)times,P＜0.001],although there were no significant differences in intraoperative blood loss,incision healing and hospital stay between the two groups(P＞0.05).All patients in both groups were followed up for more than 12 months,with an average of(26.4±5.5)months.At the last follow-up,VAS scores significantly decreased(P＜0.05),while mHHS and iHOT scores significantly increased in both groups(P＜0.05).There were no statistically significant differences in VAS,mHHS and iHOT scores between the two groups before surgery(P＞0.05).At the last follow-up,the NFS group was greater than the FS group in terms of VAS and mHHS scores,and the former was less than the latter in IHOT-12 scores,whereas all of the differences in abovementioned parameters proved not statistically significant be-tween the two groups(P＞0.05).In terms of imaging,the lateral center-edge angle(LCEA)and acetabular index(AI)in both groups signifi-cantly improved at the last follow-up compared with those before surgery(P＜0.05),whereas which were not significantly different between the two groups at any time points accordingly(P＞0.05).[Conclusion]Both non-fluoroscopy and conventional fluoroscopy arthroscopic ace-tabuloplasty do achieve good clinical results,with no significant differences between the two methods,but the former does save operation time and reduce the impact of radiation on health.
关键词
髋关节撞击综合征/钳夹型/关节镜手术/髋臼成形术Key words
femoroacetabular impingement/pincer type/arthroscopic surgery/acetabuloplasty引用本文复制引用
出版年
2024
NETL
NSTL
万方数据