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Journal of Hip Preservation Surgery最新文献

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Failed labral reconstruction of the hip can be successfully revised to another labral reconstruction: improved patient-reported outcomes at a minimum of 2-year follow-up. 失败的髋关节唇部重建可以成功地修正为另一个唇部重建:在至少2年的随访中改善了患者报告的结果。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-10-01 eCollection Date: 2024-12-01 DOI: 10.1093/jhps/hnae033
Brian J White, R Presley Swann, Hannah Spears, Anna Shafer, Shannon M Constantinides

The purpose of this study was to validate the success of revision arthroscopic circumferential allograft labral reconstruction (CLR) in nonarthritic hips, which, in the rare case of failure, had previously undergone labral reconstruction by the same surgeon. Using a minimum of 24-month follow-up, data from 24 hips having undergone revision CLR were analyzed to determine improvements in patient-reported outcomes (PROs). All included cases completed a minimum of 24 months follow-up, with a success rate of 96%. All PROs improved significantly, with exceptionally strong measures of effect. Modified Harris Hip Scores improved by a mean of 26.68 points, with 88% of patients meeting the minimal clinically important difference (MCID) (+6.49, P ≤ .001, d = 1.32). Lower Extremity Functional Scale scores improved by a mean of 21.88 points, with 78% of patients meeting the MCID (+7.79, P ≤ .001, d = 1.32). Pain as rated by the Visual Analog Scale, including at rest, during activities of daily living, and with sports, was significantly improved with strong measures of effect, with >75% of patients having met the MCID. This study validated that a failed labral reconstruction of the hip can be revised safely and effectively to another labral reconstruction of the hip. While labral reconstruction has broadly been shown to result in highly favorable outcomes, this study demonstrated that in the rare case of failure, revision CLR is not only feasible but results in improved pain and functionality.

本研究的目的是验证翻修关节镜下环缘同种异体唇瓣重建术(CLR)在非关节炎髋关节中的成功,在罕见的失败情况下,以前曾由同一外科医生进行过唇瓣重建术。通过至少24个月的随访,分析了24个髋关节的翻修CLR数据,以确定患者报告的预后(PROs)的改善。所有纳入的病例完成了至少24个月的随访,成功率为96%。所有的PROs都有了显著的改善,效果非常明显。改良Harris髋关节评分平均提高26.68分,88%的患者达到最小临床重要差异(MCID) (+6.49, P≤)。001, d = 1.32)。下肢功能量表评分平均提高21.88分,78%的患者达到MCID (+7.79, P≤)。001, d = 1.32)。根据视觉模拟量表(Visual analogue Scale)评定的疼痛,包括休息、日常生活活动和运动时的疼痛,都得到了显著改善,效果显著,约75%的患者达到了MCID。本研究证实,失败的髋关节唇部重建可以安全有效地进行另一次髋关节唇部重建。虽然唇部重建已广泛显示出非常好的结果,但本研究表明,在极少数失败的情况下,翻修CLR不仅可行,而且可以改善疼痛和功能。
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引用次数: 0
Is core decompression and bone marrow concentrate with demineralized bone matrix and platelet-rich fibrin suitable for treating femoral head osteonecrosis? 核心减压术和含有脱矿物质骨基质和富血小板纤维蛋白的骨髓浓缩物是否适合治疗股骨头坏死?
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-14 DOI: 10.1093/jhps/hnae031
Luca Cevolani, Marco Focaccia, Benedetta Spazzoli, Alessandro Bruschi, Eric Lodewijk Staals, Barbara Dozza, Roberta Laranga, Tommaso Frisoni, Andrea Sambri, Andrea Montanari, Giuseppe Bianchi, Davide Maria Donati
The aim of this article is to determine the safety and efficacy of core decompression (CD) combined with injection of autologous bone marrow concentrate (BMC), demineralized bone matrix (DBM), and platelet-rich fibrin (PRF) for treating femoral head osteonecrosis. Seventy-seven patients (53 males and 24 females) for a total of 87 hips were treated for hip osteonecrosis with CD combined with injection of autologous BMC, DBM, and PRF at Rizzoli Orthopedic Institute from September 2008 to December 2019. Patients were assessed at baseline, at 45 days, and at 3, 6, 12, 24, and 36 months postoperatively. The primary outcome was the survival rate of hips not converted to total hip arthroplasty (THA). The secondary outcomes were (I) radiographic positive evolution assessed by X-ray films and magnetic resonance imaging and (II) the clinical symptoms evaluated with the Harris Hip Score (HHS). Eighty-seven hips from 77 patients with femoral head osteonecrosis (FHON), 60 males and 27 females, with a median age of 34 years (range 15–55) were included. The cause of necrosis was steroid treatment in 30 patients (17 of these for hematological malignancies, 2 for lupus, 1 for Churg–Strauss syndrome, and the remaining for other causes), 1 was alcohol-related, 4 followed hip injury, while 15 patients had idiopathic causes. THA was carried out in 20 hips (40%). These patients had lesions classified as IIa on the Ficat stage in four cases, six were IIb, nine were III, and one was 4. No CD-related complications were found during THA surgery or at the last follow-up in these cohorts of patients. Radiographic progression of the FHON was found in 14 hips (28%), with a higher percentage on Ficat’s stage IIb. There were procedure-related complications in two hips, including one femoral neck fracture and one deep infection. Nineteen hips with successful treatment had good to excellent functional results at a 3-year follow-up or more (HHS ≥ 80). The long-term outcomes of treatment with CD and injection with BMC combined with DBM and PRF are promising to prevent femoral head collapse in patients with FHON. Moreover, CD does not influence the outcome in cases of THA.
本文旨在确定核心减压(CD)联合注射自体骨髓浓缩物(BMC)、去矿物质骨基质(DBM)和富血小板纤维蛋白(PRF)治疗股骨头坏死的安全性和有效性。2008年9月至2019年12月,瑞佐利骨科研究所对77名患者(53名男性和24名女性)共87个髋关节进行了CD联合注射自体骨髓浓缩物、去矿物质骨基质和富血小板纤维蛋白治疗髋关节骨坏死的治疗。对患者进行了基线、45 天、术后 3、6、12、24 和 36 个月的评估。主要结果是未转为全髋关节置换术(THA)的髋关节存活率。次要结果是:(I) 通过X光片和磁共振成像评估的放射学阳性进展;(II) 通过哈里斯髋关节评分(HHS)评估的临床症状。77例股骨头坏死(FHON)患者的87个髋关节被纳入研究,其中男性60例,女性27例,中位年龄34岁(15-55岁)。30例患者的坏死原因为类固醇治疗(其中17例为血液恶性肿瘤,2例为狼疮,1例为丘格-斯特劳斯综合征,其余为其他原因),1例与酒精有关,4例为髋关节损伤,15例为特发性原因。20例(40%)髋关节接受了全髋关节置换术。在这些患者中,4 例患者的病变在 Ficat 分期中被归类为 IIa,6 例为 IIb,9 例为 III,1 例为 4。有14个髋关节(28%)的FHON出现放射学进展,其中Ficat分期为IIb的比例较高。有两个髋关节出现了手术相关并发症,包括一个股骨颈骨折和一个深部感染。19个治疗成功的髋关节在3年或更长时间的随访中获得了良好至卓越的功能效果(HHS≥80)。CD和注射BMC联合DBM和PRF治疗的长期疗效对预防FHON患者的股骨头塌陷很有帮助。此外,CD不会影响THA的疗效。
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引用次数: 0
Victorian Institute of Sport Assessment questionnaire specifically tailored for greater trochanteric pain syndrome for the Dutch population 维多利亚体育学院专门为荷兰人量身定制的大转子疼痛综合征评估问卷
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-08-28 DOI: 10.1093/jhps/hnae026
Damien Van Quickenborne, Catherine Van Der Straeten, Arne Burssens, Emmanuel Audenaert
Greater trochanteric pain syndrome (GTPS) is a highly prevalent condition characterized by lateral hip and thigh pain. The Victorian Institute of Sport Assessment (VISA) questionnaire specifically tailored for GTPS (VISA-G) questionnaire was developed for the purpose of assessing and quantifying the severity of symptoms related to gluteal tendinopathy or GTPS. It is commonly used in research and clinical settings to evaluate the impact of GTPS on patient function and quality of life. The VISA-G questionnaire was developed for English-speaking populations. Before this questionnaire can be used in non-English-speaking populations, it has to be translated and validated for a particular population. The current study aimed to translate and validate the VISA-G questionnaire for a Dutch-speaking context (VISA-G-Dutch). In this study, we conducted a comprehensive process involving forward and back translation, along with a thorough comparison with other established hip-related questionnaires. The COSMIN checklist was used to ensure uniformity in the validation study. A sample of 100 participants, 50 symptomatic and 50 asymptomatic, completed the VISA-G-Dutch, Harris Hip Score, Hip Disability and Osteoarthritis Outcome Score, Oxford Hip Score, and Nonarthritic Hip Score questionnaires. Internal consistency and test–retest reliability were measured. Construct validity was assessed through positive correlations between the VISA-G-Dutch and gold standard questionnaires. Strong internal consistency and test–retest reliability correlations were found in both the asymptomatic and symptomatic groups. The test–retest reliability also demonstrated strong positive correlations for the symptomatic group. The standard error of measurement was ∼2.3 for the symptomatic group. These results prove that the VISA-G-Dutch is a reliable and valid tool for assessing GTPS and gluteal tendinopathy in Dutch-speaking individuals, providing clinicians with a valuable assessment tool.
大转子疼痛综合征(GTPS)是一种以臀部和大腿外侧疼痛为特征的高发疾病。维多利亚州运动评估研究所(VISA)专门为大转子疼痛综合征(GTPS)定制了一份问卷(VISA-G),用于评估和量化与臀肌腱病或大转子疼痛综合征有关的症状的严重程度。它通常用于研究和临床环境,以评估 GTPS 对患者功能和生活质量的影响。VISA-G 问卷是专为讲英语的人群开发的。在将该问卷用于非英语国家人群之前,必须针对特定人群对其进行翻译和验证。本研究旨在翻译并验证荷兰语环境下的 VISA-G 问卷(VISA-G-荷兰语)。在这项研究中,我们进行了全面的翻译工作,包括正译和反译,并与其他已有的髋关节相关问卷进行了全面比较。为确保验证研究的统一性,我们使用了 COSMIN 核对表。100 名参与者(50 名有症状者和 50 名无症状者)完成了 VISA-G-荷兰语、哈里斯髋关节评分、髋关节残疾和骨关节炎结果评分、牛津髋关节评分和非关节炎髋关节评分问卷。对内部一致性和重复测试可靠性进行了测量。通过 VISA-G-Dutch 与黄金标准问卷之间的正相关性评估了结构效度。在无症状组和有症状组都发现了很强的内部一致性和测试-再测可靠性相关性。症状组的重测信度也显示出很强的正相关性。无症状组的测量标准误差为 2.3。这些结果证明,VISA-G-Dutch 是评估荷语人群 GTPS 和臀部肌腱病的可靠有效的工具,为临床医生提供了有价值的评估工具。
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引用次数: 0
Self-reported preoperative anxiety and depression associated with worse patient-reported outcomes for periacetabular osteotomy and hip arthroscopy surgery 自我报告的术前焦虑和抑郁与髋关节周围截骨术和髋关节镜手术患者报告的较差结果有关
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-08-22 DOI: 10.1093/jhps/hnae029
Ann E Richey, Nicole Segovia, Katherine Hastings, Christian Klemt, Stephanie Y Pun
Adverse mental health status has been linked to less successful surgical outcomes across several orthopaedic subspecialties. Mental health represents a modifiable risk factor that can be optimized preoperatively to maximize outcomes for hip preservation surgery. This study examines the relationship between preoperative mental health status and preoperative and postoperative outcomes for adolescent and adult patients undergoing hip preservation surgery. A prospectively enrolled registry of patients undergoing periacetabular osteotomy or hip arthroscopy at a single institution between 2013 and 2021 was retrospectively reviewed to collect demographics and outcomes before and after surgery. We identified patients self-reporting anxiety/depression or no anxiety/depression preoperatively based on responses to the EuroQol-5D anxiety/depression dimension and compared their preoperative and postoperative Hip disability and Osteoarthritis Outcome Scores (HOOSs) using multivariable linear models and multivariable mixed effects models. Seventy-three patients were included, 40 patients with no anxiety/depression and 33 patients with anxiety/depression. Patients with anxiety/depression had worse preoperative HOOS pain (b = −12.5, P = .029), function in daily living (b = −12.0, P = .045), function in sports and recreational activities (b = −15.1, P = .030), and quality of life (b = −16.3, P = .005) as compared to patients with no anxiety/depression. Patients with anxiety/depression had worse postoperative HOOS compared to patients with no anxiety/depression, but these associations were not statistically significant after adjusting for preoperative HOOS. There were no significant differences between both groups for percent achieving minimal clinically important difference. Patients who reported anxiety/depression preoperatively had worse preoperative pain and function before hip preservation surgery, with both groups achieving similar levels of clinical effectiveness.
在多个骨科亚专科中,不良的心理健康状况都与手术效果不理想有关。心理健康是一个可调节的风险因素,可以在术前进行优化,以最大限度地提高保留髋关节手术的效果。本研究探讨了接受保留髋关节手术的青少年和成人患者术前心理健康状况与术前和术后效果之间的关系。我们对 2013 年至 2021 年期间在一家机构接受髋臼周围截骨术或髋关节镜手术的患者进行了前瞻性登记,并对其进行了回顾性审查,以收集人口统计数据和手术前后的结果。我们根据患者对EuroQol-5D焦虑/抑郁维度的反应确定了术前自述焦虑/抑郁或无焦虑/抑郁的患者,并使用多变量线性模型和多变量混合效应模型比较了他们术前和术后的髋关节残疾和骨关节炎结果评分(HOOSs)。共纳入 73 名患者,其中 40 名患者无焦虑/抑郁,33 名患者有焦虑/抑郁。与无焦虑/抑郁的患者相比,焦虑/抑郁患者术前的 HOOS 疼痛(b = -12.5,P = .029)、日常生活功能(b = -12.0,P = .045)、运动和娱乐活动功能(b = -15.1,P = .030)和生活质量(b = -16.3,P = .005)均较差。与没有焦虑/抑郁的患者相比,有焦虑/抑郁的患者术后 HOOS 更差,但在调整术前 HOOS 后,这些相关性在统计学上并不显著。在达到最小临床意义差异的百分比方面,两组之间没有明显差异。术前报告焦虑/抑郁的患者在保留髋关节手术前的疼痛和功能较差,但两组患者的临床疗效相似。
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引用次数: 0
Comparing outcomes of hip arthroscopy and periacetabular osteotomy for the treatment of borderline hip dysplasia: a systematic review 比较髋关节镜和髋臼周围截骨术治疗边缘性髋关节发育不良的疗效:系统性综述
IF 1.5 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-08-02 DOI: 10.1093/jhps/hnae028
Alexander B Alvero, Michael J Vogel, Joshua Wright-Chisem, Shane J Nho
Hip arthroscopy (HA) and periacetabular osteotomy (PAO) are common hip preservation procedures pursued in borderline hip dysplasia (BHD), yet there is no consensus on the preferred treatment. This systematic review aims to synthesize the present literature on HA and PAO for the management of BHD. A review of multiple electronic databases was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All studies that reported outcomes of patients with BHD treated by PAO or HA with capsular closure were included. PROs, complications, and rates of subsequent surgery were evaluated. A total of 14 studies met criteria for inclusion. Eight reported outcomes following PAO and seven reported outcomes following HA. One study reported outcomes of both procedures. Both PAO and HA studies demonstrated significant improvement in PROs. Complication rates in PAO patients ranged from 0% to 7.8% compared to 0% in HA patients. Total hip arthroplasty (THO) conversion rates in PAO patients ranged from 0% to 10.5% compared to 0% to 23.7% in HA patients. Hardware removal was performed in 25–51% of PAO patients. PAO conversion following failed HA occurred in 0–6.1% of patients. Rates of other reoperation (excluding hardware removal) in PAO patients ranged from 0% to 22.2% compared to 0% to 7.9% in HA patients. Based on the current evidence, both PAO and HA demonstrate significant improvement in PROs with a low conversion rate to THA, yet additional long-term follow-up studies are required.
髋关节镜(HA)和髋臼周围截骨术(PAO)是边缘性髋关节发育不良(BHD)患者常用的保髋手术,但对于首选的治疗方法尚未达成共识。本系统性综述旨在总结目前关于HA和PAO治疗BHD的文献。我们采用《系统综述和元分析首选报告项目》指南对多个电子数据库进行了综述。所有报告了采用 PAO 或 HA 进行囊袋闭合治疗的 BHD 患者疗效的研究均被纳入其中。研究对患者的PROs、并发症和后续手术率进行了评估。共有 14 项研究符合纳入标准。其中 8 项报告了 PAO 治疗后的结果,7 项报告了 HA 治疗后的结果。一项研究报告了两种手术的结果。PAO 和 HA 两项研究均显示 PROs 有显著改善。PAO 患者的并发症发生率为 0% 至 7.8%,而 HA 患者的并发症发生率为 0%。PAO 患者的全髋关节置换术(THO)转换率为 0% 至 10.5%,而 HA 患者的转换率为 0% 至 23.7%。25%-51%的 PAO 患者进行了硬件移除。0-6.1%的患者在HA手术失败后转为PAO手术。PAO 患者的其他再手术率(不包括硬件移除)从 0% 到 22.2% 不等,而 HA 患者的再手术率从 0% 到 7.9% 不等。根据目前的证据,PAO 和 HA 都能显著改善患者的 PROs,而且转为 THA 的比例较低,但仍需进行更多的长期随访研究。
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引用次数: 0
Hip dysplasia-the Bernese contribution continues. 髋关节发育不良--伯尔尼人的贡献仍在继续。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-25 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnae019
Richard E Field
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引用次数: 0
What the papers say. 报纸怎么说
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-07-25 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnae021
Ali Bajwa
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引用次数: 0
Correction to: Long Covid-a cause of concern for surgical training. 更正:长冠状病毒——引起外科培训关注的原因。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-06-29 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnae023

[This corrects the article DOI: 10.1093/jhps/hnac039.].

[此处更正了文章 DOI:10.1093/jhps/hnac039]。
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引用次数: 0
Correction to: Long Roads. 更正:漫漫长路。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-06-26 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnae025

[This corrects the article DOI: 10.1093/jhps/hnae001.].

[更正文章DOI: 10.1093/jhps/hnae001.]。
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引用次数: 0
Correction to: In search of excellence. 更正:追求卓越。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-06-26 eCollection Date: 2024-07-01 DOI: 10.1093/jhps/hnae024

[This corrects the article DOI: 10.1093/jhps/hnad045.].

[更正文章DOI: 10.1093/jhps/hnad045.]。
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引用次数: 0
期刊
Journal of Hip Preservation Surgery
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