Journal of Hip Preservation Surgery最新文献_第3页

Author response to 'Comparing analgesic effect of regional block after hip arthroscopy'.

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-05-16 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnae007

Liangjing Yuan, Chengshi Xu, Ye Zhang, Geng Wang

引用次数: 0

Combined hip arthroscopy with periacetabular osteotomy for hip dysplasia: a systematic review 髋关节镜联合髋臼周围截骨术治疗髋关节发育不良：系统性综述

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-04-18 DOI: 10.1093/jhps/hnae016

Kenneth J Lukas, Reza Ojaghi, Kednapa Thavorn, Sasha Carsen, Kevin Smit, Paul E Beaulé

Periacetabular osteotomy (PAO) is a surgical procedure that corrects acetabular dysplasia without necessarily addressing intra-articular pathology. Hip arthroscopy is being increasingly used to address soft tissue pathologies at the time of a PAO. This review aims to determine patient-reported outcome measure scores (PROMs) of combining hip arthroscopy and PAO. This systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines to identify English studies that reported upon patient populations that had PAO’s performed with arthroscopy at the time of surgery for correcting developmental hip dysplasia. We identified 428 articles; 14 full-text articles met the inclusion criteria. Between 2011 and 2022, 1083 hips from the selected articles underwent a combined PAO and arthroscopic procedure, with a mean follow-up of 3.7 years. Of the studies that reported it, 63% of the evaluated population were found to have labral tears that required either labral repair (49%), labral debridement (12%) or combined procedure. Multiple PROMs were identified in the literature, with no standardized reporting system used between articles. All articles reported statistically improved patient-reported outcomes from a combined PAO and arthroscopy procedure. There was no difference in PROMs when comparing PAO performed with or without arthroscopy. One study suggested superior outcomes for active individuals who underwent PAO and arthroscopy. Patient-reported outcome scores improve significantly after PAO with or without arthroscopy, with no differences in adverse events, and only limited evidence that active individuals benefit from labral repair.

髋臼周围截骨术（PAO）是一种矫正髋臼发育不良的手术方法，但不一定要治疗关节内病变。髋关节镜越来越多地用于治疗 PAO 时的软组织病变。本综述旨在确定结合髋关节镜和 PAO 的患者报告结果测量评分 (PROM)。本系统性综述遵循《系统性综述和荟萃分析的首选报告项目》（Preferred Reporting Items for Systematic Review and Meta-Analyses）指南，以鉴别那些报告了在矫正发育性髋关节发育不良手术时进行 PAO 和关节镜手术的患者群体的英文研究。我们确定了 428 篇文章，其中 14 篇全文符合纳入标准。2011 年至 2022 年间，所选文章中有 1083 例髋关节接受了 PAO 和关节镜联合手术，平均随访时间为 3.7 年。在报告的研究中，63%的受评人群被发现有唇裂，需要进行唇裂修补术（49%）、唇裂清创术（12%）或联合手术。文献中发现了多种PROMs，但文章之间没有使用标准化的报告系统。所有文章都报告了 PAO 和关节镜联合手术在统计学上改善了患者报告的结果。在比较PAO与关节镜手术时，PROM没有差异。一项研究表明，接受 PAO 和关节镜手术的活跃患者的疗效更好。无论是否进行了关节镜手术，PAO术后患者报告的结果评分都有明显改善，不良事件方面没有差异，只有有限的证据表明活动量大的患者可从唇瓣修复术中获益。

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引用次数: 0

High prevalence of former elite ice hockey players requiring early hip arthroplasty surgery 前冰上曲棍球精英运动员需要尽早进行髋关节置换手术的比例很高

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-04-18 DOI: 10.1093/jhps/hnae017

Josefin Abrahamson, Ida Lindman, Pall Jónasson, Yelverton Tegner

The high-impact nature of ice hockey puts the players at a higher risk of developing early hip osteoarthritis (OA). This study aims to evaluate the presence of cam morphology, early radiological findings of OA and total hip arthroplasty (THA) in former Swedish elite ice hockey players. Male elite ice hockey players in the highest league in Sweden seeking orthopedic consultation for hip and groin pain with restricted hip joint range of motion and subsequent radiographs (Antero/posterior view, Lauenstein view and/or Hip frontal view) were included. The radiographs were performed between 1988 and 2009 and retrospectively examined for the presence of cam morphology (evaluated by α-angle ≥ 60°) and hip OA (evaluated by Tönnis classification). All players were contacted between 11 and 33 years after baseline radiograph examination for follow-up investigation of the presence of subsequent THA. A total of 44 male ice hockey players were included, of which 31 had available radiographs and 39 answered the follow-up questions. Cam morphology (α-angle ≥60°) was present in 81% of the players. Seven players (18%) had received a THA with a mean age of 55.7 (SD 6.1) years at time of THA-surgery. Tönnis score at baseline radiographs were associated with THA later in life (P < 0.001). This study conclude that former elite Swedish ice hockey players underwent THA at a younger age than the general population. Despite confirming previous research of high prevalence of cam morphology in elite ice hockey players, no association could be established between cam morphology and the need for THA.

冰上曲棍球运动的高冲击性使运动员罹患早期髋关节骨性关节炎（OA）的风险更高。本研究旨在评估前瑞典精英冰上曲棍球运动员是否存在凸轮形态、OA的早期放射学发现以及全髋关节置换术（THA）。研究对象包括瑞典最高级别联赛中因髋部和腹股沟疼痛、髋关节活动范围受限而寻求骨科会诊的男性冰上曲棍球精英运动员，以及随后接受放射线检查（前/后视图、劳恩斯坦视图和/或髋关节正面视图）的运动员。这些照片是在 1988 年至 2009 年期间拍摄的，并对是否存在凸轮形态（通过 α 角≥ 60°进行评估）和髋关节 OA（通过 Tönnis 分类进行评估）进行了回顾性检查。所有球员均在基线射线检查后 11 至 33 年间接受了跟踪调查，以确定是否存在后续的 THA。共纳入 44 名男性冰上曲棍球运动员，其中 31 人有可用的 X 光片，39 人回答了后续问题。81%的球员存在凸轮形态（α角≥60°）。7名球员（18%）接受过全踝关节置换术，全踝关节置换术时的平均年龄为55.7岁（标准差6.1岁）。基线X光片上的Tönnis评分与日后的THA有关（P < 0.001）。这项研究得出结论，前瑞典冰上曲棍球精英运动员接受全膝关节置换术的年龄比一般人要小。尽管之前的研究证实了冰上曲棍球精英运动员凸轮形态的高患病率，但凸轮形态与是否需要接受全膝关节置换术之间并无关联。

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引用次数: 0

Feasibility and potential of intraoperative ultrasound in arthroscopy of femoroacetabular impingement. 术中超声在股髋臼撞击关节镜检查中的可行性和潜力。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-04-11 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnad050

Zhuohua Lin, Ligang Cui, Yan Xu, Qiang Fu, Youjing Sun

This study aimed to evaluate the feasibility of using ultrasound for monitoring osteochondroplasty intraoperatively, determine the factors that interfere with ultrasound imaging and assess its influence on surgeon performance. Intraoperative ultrasonography was performed during osteochondroplasty in 39 cases of arthroscopy. The femoral head-neck junction (FHNJ) was evaluated using ultrasonography. Another 39 cases, which underwent conventional arthroscopy, were included in the control group. The C-arm was used in this group at the end of osteochondroplasty to confirm that no residual cam lesion remained. Pre- and postoperative Dunn radiographs and computed tomography (CT) scans were analyzed to determine the feasibility of ultrasound. Residual cam deformity was noted in eight cases under ultrasound. The FHNJ was not detected owing to ultrasound interference by air in three cases. No difference in the α angle measured in Dunn radiographs and the residual cam deformity rate of CT at the 1:00, 2:00 or 3:00 position was found between both groups. However, the α angle at the 3:00 position was greater in the ultrasound group than in the control group (44.4 ± 4.3° versus 41.3 ± 5.1°, P < 0.05), suggesting that more bone was preserved at 3:00 in the ultrasound group. No difference was found in the mean operation time. None of the patients experienced complications, such as wounds or intra-articular infections. Ultrasound is a safe method for assessing FHNJ during arthroscopy. It did not change the risk of residual cam deformity but positively affected the surgeon's performance by reducing unnecessary bone removal.

本研究旨在评估术中超声监测骨软骨成形术的可行性，确定干扰超声成像的因素，并评估其对外科医生表现的影响。对39例关节镜下骨软骨成形术进行术中超声检查。超声检查股骨头颈结（FHNJ）。另外39例患者行常规关节镜检查作为对照组。本组在骨软骨成形术结束时使用c型臂，以确认没有残留的凸轮病变。分析术前和术后Dunn x线片和计算机断层扫描（CT）以确定超声的可行性。超声检查发现8例残cam畸形。在3例中，由于空气的超声干扰，未检测到FHNJ。两组在1:00、2:00、3:00位置的Dunn片α角测量值及CT残cam畸形率均无差异。超声组3:00位α角明显大于对照组(44.4±4.3°比41.3±5.1°，P

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引用次数: 0

What the papers say. 报纸怎么说

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-04-09 eCollection Date: 2024-01-01 DOI: 10.1093/jhps/hnae005

Ali Bajwa

引用次数: 0

Current trends for venous thromboembolic prophylaxis for hip arthroscopy: a modified Delphi and nominal group technique consensus study 髋关节镜手术静脉血栓栓塞预防的当前趋势：改良德尔菲和名义小组技术共识研究

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-04-08 DOI: 10.1093/jhps/hnae014

Ali Parsa, Asheesh Bedi, Benjamin G Domb

The overall risk of venous thromboembolism (VTE) after hip arthroscopy (HA) is reported to range from 0.2% to 9.5%, but a clear set of recommendations for VTE prophylaxis in HA patients remains scarce. The aim is to survey high-volume hip arthroscopists about their current trends regarding VTE prophylaxis use. A combination of two consensus group methods was used in this study: nominal group technique (NGT) and modified Delphi. A preliminary questionnaire was prepared, and rounds of discussion were completed between NGT members. The final version of the survey was administered to 35 high-volume hip surgeons. Delegates’ mean volume of annual hip arthroscopic surgery was 109. Approximately 22% of their patients are revision HA procedures. A total of 91.4% of delegates use chemoprophylaxis, 28.6% use sequential compression devices and 91.4% believed that chemoprophylaxis is necessary for more prolonged and complex procedures (strong consensus). Aspirin was the choice for all participants, and the duration was 2–3 weeks (31.4%), 1 month (65.7%) and 2–3 months (2.9%). History of VTE, hypercoagulable status, and malignancy were considered risk factors. No consensus was achieved for the discontinuation of oral contraceptive and smoking preoperatively. However, the optimal length of VTE prophylaxis is unclear. A total of 97.1% of the experts responded that they administer aspirin between 2 and 4 weeks. High-volume arthroscopic surgeons do consider VTE prophylaxis to be important and warranted in the postoperative setting. Aspirin is the mainstay of chemoprophylaxis, although the appropriate duration is unknown.

据报道，髋关节镜（HA）术后发生静脉血栓栓塞（VTE）的总体风险在 0.2% 到 9.5% 之间，但关于 HA 患者 VTE 预防的一系列明确建议仍然很少。我们的目的是调查工作量大的髋关节镜医生目前使用 VTE 预防措施的趋势。本研究结合使用了两种共识小组方法：名义小组技术（NGT）和改良德尔菲法。我们准备了一份初步调查问卷，并在 NGT 成员之间进行了多轮讨论。最终版本的调查问卷由 35 名工作量大的髋关节外科医生填写。代表们每年髋关节镜手术的平均数量为 109 例。他们的患者中约有 22% 接受过髋关节镜翻修手术。91.4%的代表使用化学预防，28.6%的代表使用连续加压装置，91.4%的代表认为化学预防对于更长时间和更复杂的手术是必要的（强烈共识）。阿司匹林是所有与会者的选择，持续时间分别为 2-3 周（31.4%）、1 个月（65.7%）和 2-3 个月（2.9%）。有 VTE 病史、高凝状态和恶性肿瘤被认为是风险因素。关于术前停用口服避孕药和禁烟，尚未达成共识。然而，预防 VTE 的最佳时间尚不明确。97.1%的专家回答说他们会在 2 到 4 周内服用阿司匹林。工作量大的关节镜外科医生确实认为 VTE 预防很重要，而且在术后环境中也有必要。阿司匹林是化学预防的主要药物，但适当的用药时间尚不清楚。

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引用次数: 0

Clinical outcomes after hip arthroscopy in acetabular dysplastic patients, previously treated with periacetabular osteotomy: a minimum of two-year follow-up data from the Danish Hip Arthroscopy Registry. 先前接受髋臼周围截骨治疗的髋臼发育不良患者髋关节镜后的临床结果：来自丹麦髋关节镜登记中心的至少两年随访数据。

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-04-08 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnae015

Bjarne Mygind-Klavsen, Bent Lund, Torsten Grønbech Nielsen, Martin Lind

Periacetabular osteotomy (PAO) is the treatment of choice in dysplastic acetabulum. Due to continued symptoms, 2-11% of these patients require an additional hip arthroscopy. The purpose of this study was to report clinical outcome after a minimum of 2-year follow-up of additional hip arthroscopy after PAO with data from Danish Hip Arthroscopy Registry. Inclusion criteria in the study cohort were PAO surgery resulting in an additional hip arthroscopy procedure. The cohort was evaluated according to the surgical findings and patient-related outcome measures (PROMs) pre-operatively and at 2-year follow-up. A total of 287 patients were included in the study cohort. PROMs improved significantly in all subscales from pre-operatively to 2-year follow-up in the study cohort. According to PROM subscales, 47.8-57.6% and 25.2-38.2% achieved Minimal Clinical Important Difference and Patient Acceptable Symptom State, respectively. This study demonstrates, in PAO-treated patients, significant PROM improvements after additional hip arthroscopy. Unfortunately, only ∼50% and 30% achieved Minimal Clinical Important Difference and Patient Acceptable Symptom State, respectively.

髋臼周围截骨术（PAO）是治疗髋臼发育不良的首选方法。由于症状持续存在，2%-11% 的患者需要再次进行髋关节镜检查。本研究的目的是利用丹麦髋关节镜注册中心的数据，报告 PAO 术后追加髋关节镜手术至少 2 年随访后的临床结果。研究队列的纳入标准是 PAO 手术后进行了额外的髋关节镜检查。根据手术结果和患者相关结局指标（PROMs）对患者进行术前评估和两年随访。共有 287 名患者被纳入研究队列。从术前到两年随访期间，研究队列中所有子量表的PROM均有明显改善。根据 PROM 分量表，分别有 47.8% 至 57.6% 和 25.2% 至 38.2% 的患者达到了 "最小临床重要差异"（Minimal Clinical Important Difference）和 "患者可接受症状状态"（Patient Acceptable Symptom State）。这项研究表明，经过 PAO 治疗的患者在接受额外的髋关节镜手术后，PROM 有明显改善。遗憾的是，分别只有50%和30%的患者达到了最小临床重要差异和患者可接受症状状态。

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引用次数: 0

Quantifying radiation exposure in the radiological investigation of non-arthritic hip pain 量化非关节炎性髋关节疼痛放射学检查中的辐照量

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-04-01 DOI: 10.1093/jhps/hnae013

Alistair Iw Mayne, Ahmed Saad, Rajesh Botchu, Lucie Gosling, Peter Wall, Angelos Politis, Peter D’Alessandro, Callum McBryde

Radiological investigations are essential for evaluating underlying structural abnormalities in patients presenting with non-arthritic hip pain. The aim of this study is to quantify the radiation exposure associated with common radiological investigations performed in assessing patients presenting with non-arthritic hip pain. A retrospective review of our institutional imaging database was performed. Data were obtained for antero-posterior, cross-table lateral, frog lateral radiographs and low-dose CT hip protocol. The radiation dose of each imaging technique was measured in terms of dose-area product with units of mGy cm2, and the effective doses (ED, mSv) calculated. The effective radiation dose for each individual hip radiograph performed was in the range of 0.03–0.83 mSv [mean dose-area product 126.7–156.2 mGy cm2]. The mean ED associated with the low-dose CT hip protocol (including assessment of femoral anteversion and tibial torsion) was 3.04 mSv (416.8 mGy cm2). The radiation dose associated with the use of CT imaging was significantly greater than plain radiographs (P < 0.005). Investigation of non-arthritic hip pain can lead to significant ionizing radiation exposure for patients. In our institution, the routine protocol is to obtain an antero-posterior pelvic radiograph and then a specific hip sequence Magnetic Resonance Imaging (MRI) scan which includes the assessment of femoral anteversion. This provides the necessary information in the majority of cases, with CT scanning reserved for more complex cases where we feel there is a specific indication. We would encourage the hip preservation community to carefully consider and review the use of ionizing radiation investigations.

放射检查对于评估非关节炎性髋关节疼痛患者的潜在结构异常至关重要。本研究旨在量化在评估非关节炎性髋关节疼痛患者时进行的常见放射检查所产生的辐射量。我们对本机构的影像数据库进行了回顾性审查。我们获得了髋关节前后位、跨台侧位、蛙式侧位X光片和低剂量CT髋关节方案的数据。每种成像技术的辐射剂量均以剂量-面积乘积（单位为 mGy cm2）进行测量，并计算出有效剂量（ED，mSv）。每张髋关节 X 光片的有效辐射剂量范围为 0.03-0.83 mSv [平均剂量-面积乘积为 126.7-156.2 mGy cm2]。与低剂量 CT 髋关节方案（包括股骨内翻和胫骨扭转评估）相关的平均 ED 为 3.04 mSv（416.8 mGy cm2）。使用CT成像的辐射剂量明显高于普通X光片（P < 0.005）。非关节炎性髋关节疼痛的检查可能会导致患者暴露于大量电离辐射。我院的常规方案是先拍摄骨盆前后位X光片，然后进行特定的髋关节序列磁共振成像（MRI）扫描，其中包括股骨反转评估。这为大多数病例提供了必要的信息，CT 扫描只用于我们认为有特殊适应症的复杂病例。我们鼓励髋关节保存界仔细考虑和审查电离辐射检查的使用。

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引用次数: 0

Spinal versus general anesthesia for hip arthroscopy—a pandemic (COVID) and epidemic (opioid) driven study 髋关节镜检查中的脊髓麻醉与全身麻醉--大流行病（COVID）和流行病（阿片类药物）驱动的研究

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-03-27 DOI: 10.1093/jhps/hnae009

Thomas J. W., Kay S Jones, Nicole Dwyer, Amy M McManus, Ellen B Byrd, Wallace L Freeman

The purpose of this study is to compare general anesthesia (GA) to spinal anesthesia (SA) for hip arthroscopy, based on measurable perioperative parameters. The pandemic signaled a change from GA to SA, and thus a retrospective review was performed of the first 120 consecutive SA cases compared to the last 120 GA cases prior to the pandemic. Demographic data included age, sex, BMI, preop narcotic usage and procedure performed. The groups were compared for post-anesthesia care unit length of stay, entry and discharge visual analog scale (VAS) scores, morphine mg equivalent usage, need for regional blocks and untoward events. Additionally, the length of time from entry to the operating room until completion of induction anesthesia was compared. Demographically, the groups were virtually identical. SA used significantly less morphine mg equivalent (6.0 versus 8.1; P = 0.005), had more needing no narcotics (17 versus 7; P = 0.031), fewer requiring blocks (1 versus 14; P = 0.001) and lower entry VAS scores (5.2 versus 6.2; P = 0.003). Five early SA patients required catheterization for urinary retention, and this was avoided later in the study by having patient void on call to operating room and avoiding anticholinergic agents. Completion of induction anesthesia was 0.8 min longer for SA. Hip arthroscopy can be effectively performed with either GA or SA. SA results in statistically significant better post-anesthesia care unit pain control, reflected by lower entry VAS, less need for narcotics and fewer requiring regional blocks compared to GA. Urinary retention, a potential problem of SA, is minimized with routine precautions.

本研究的目的是根据围手术期的可测量参数，比较髋关节镜手术中的全身麻醉（GA）和脊髓麻醉（SA）。大流行标志着从GA到SA的转变，因此我们对前120例连续SA病例与大流行前最后120例GA病例进行了回顾性回顾。人口统计学数据包括年龄、性别、体重指数、术前麻醉剂使用情况和所实施的手术。比较了两组患者在麻醉后护理病房的住院时间、入院和出院时的视觉模拟量表（VAS）评分、吗啡毫克当量用量、区域阻滞需求和意外事件。此外，还比较了从进入手术室到完成诱导麻醉的时间长度。从人口统计学角度来看，两组患者几乎完全相同。SA 组使用的吗啡毫克当量（6.0 对 8.1；P = 0.005）明显较少，不需要麻醉药的人数较多（17 对 7；P = 0.031），需要阻滞的人数较少（1 对 14；P = 0.001），入院时的 VAS 评分较低（5.2 对 6.2；P = 0.003）。五名早期 SA 患者因尿潴留需要导尿，通过让患者在手术室呼叫时排尿并避免使用抗胆碱能药物，在研究后期避免了这一情况的发生。SA患者完成诱导麻醉的时间延长了0.8分钟。使用 GA 或 SA 均可有效地进行髋关节镜手术。与GA相比，SA对麻醉后护理单元疼痛的控制在统计学上有明显的改善，这体现在较低的入室VAS、较少的麻醉药需求和较少的区域阻滞需求。尿潴留是 SA 的一个潜在问题，通过常规预防措施可将其降到最低。

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引用次数: 0

A pilot screening project for the detection of hip dysplasia in young patients 检测年轻患者髋关节发育不良的试点筛查项目

IF 1.5 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery

Pub Date : 2024-03-06 DOI: 10.1093/jhps/hnae010

Frederik Berstad Møse, Shahin Mohseni, Tomas Borg

Hip dysplasia in young adults is underdiagnosed and can cause pain and discomfort. Progression to osteoarthritis (OA) is common, necessitating total hip arthroplasty at an early age. When discovered early, symptomatic patients can be offered physiotherapy and/or hip-preserving surgery to alleviate pain and decrease the risk of early OA. A pilot project to screen radiograms for hip dysplasia was started across the Swedish region of Örebro Län in January 2019, comparing the incidence of dysplasia before and after initiation of the screening program. All elective conventional radiograms of the hip (age 12–44 years), requested by primary care physicians, were analyzed by consultant radiologists according to a pre-established algorithm to identify hip abnormalities. If the hip radiograms showed dysplastic changes, or other pathological signs, the radiologist advised referral to a specialized Youth Hip Clinic for further work-up and treatment. A total of 1056 radiograms were requested by clinicians during the study periods (601 and 455 during 2018 and 2020, respectively). A total of 457 trauma-related cases were excluded, resulting in 599 available for analysis (348 and 251 during 2018 and 2020, respectively). During 2018, 17 patients (4.9%) received the radiologic diagnosis of dysplasia, compared with 44 patients (17.5%) during 2020 (P < 0. 001). A three-fold increase of patients diagnosed with hip dysplasia was detected as a result of the implementation of the screening program. The advantage of screening is early referral to an orthopedic department for evaluation and consideration for physiotherapy and/or surgical intervention.

青壮年髋关节发育不良的诊断率很低，而且会引起疼痛和不适。发展为骨关节炎（OA）很常见，需要在早期进行全髋关节置换术。如果发现得早，有症状的患者可以接受物理治疗和/或保髋手术，以减轻疼痛并降低早期 OA 的风险。2019年1月，瑞典厄勒布鲁地区启动了一项试点项目，对髋关节发育不良的X光片进行筛查，比较筛查项目启动前后的发育不良发生率。所有由初级保健医生申请的髋关节常规X光检查（12-44岁）均由放射科顾问医生根据预先制定的算法进行分析，以确定髋关节是否异常。如果髋部 X 光片显示有发育不良的变化或其他病理征兆，放射科医生会建议转诊到专门的青少年髋部门诊进行进一步检查和治疗。在研究期间，临床医生共要求进行了 1056 次射线造影（2018 年和 2020 年分别为 601 次和 455 次）。共排除了 457 例外伤相关病例，因此有 599 例可供分析（2018 年和 2020 年分别为 348 例和 251 例）。2018 年期间，17 名患者（4.9%）获得了发育不良的放射诊断，而 2020 年期间，44 名患者（17.5%）获得了发育不良的放射诊断（P < 0.）由于实施了筛查计划，被诊断为髋关节发育不良的患者增加了三倍。筛查的优势在于及早转诊至骨科部门进行评估，并考虑物理治疗和/或手术干预。

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引用次数: 0