强调萘普生预防的重要性可降低髋关节镜检查后异位骨化的发生率

Q3 Medicine Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-08-01 DOI:10.1016/j.asmr.2024.100941

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引用次数: 0

摘要

目的研究在引入标准化教育方案前后，开具预防性非甾体类抗炎药（NSAIDs）的患者中异位骨化（HO）的发生率。方法对一家学术医院的一名外科医生在 2015 年至 2023 年期间治疗的髋关节镜患者数据库进行回顾性审查。纳入标准为：（1）为治疗股骨髋臼撞击症而接受初次髋关节镜手术；（2）完成为期两周的术后非甾体抗炎药预防性治疗（500 毫克萘普生，每天两次）；（3）术后 6 个月随访时提供随访 X 光片。对照组仅开具术后预防性非甾体抗炎药，而干预组还接受了专门的面对面教育，强调坚持服用非甾体抗炎药的重要性。通过复查随访X光片确定是否存在HO。结果对照组和干预组均由200名连续接受髋关节镜检查的患者组成，对照组的治疗时间为2015年至2017年，干预组的治疗时间为2020年至2023年。对照组发现10例HO（5%）。干预组发现 2 例 HO（1%）。结论在这项研究中，我们发现接受了关于非甾体抗炎药依从性重要性的标准化教育的患者与未接受此类教育的患者相比，HO 的发病率明显降低。这一发现表明，患者教育可能有助于降低髋关节镜手术后HO的发生率。

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Emphasizing the Importance of Naproxen Prophylaxis May Decrease the Rate of Heterotopic Ossification After Hip Arthroscopy

Purpose

To investigate the incidence of heterotopic ossification (HO) in patients prescribed prophylactic nonsteroidal anti-inflammatory drugs (NSAIDs), both before and after the introduction of a standardized education protocol.

Methods

A retrospective review was conducted using a database of hip arthroscopy patients treated by a single surgeon at an academic hospital from 2015 to 2023. The inclusion criteria were (1) primary hip arthroscopy for the treatment of femoroacetabular impingement, (2) completion of a 2-week course of prophylactic postoperative NSAIDs (500 mg of naproxen twice daily), and (3) availability of follow-up radiographs at the 6-month postoperative visit. The control cohort was merely prescribed the postoperative prophylactic NSAIDs, whereas the intervention cohort also received dedicated in-person education, emphasizing the importance of NSAID adherence. The presence of HO was determined through review of follow-up radiographs. Standard descriptive statistics were used to describe the findings.

Results

Both the control and intervention groups consisted of 200 continuous hip arthroscopy patients, with the control group treated from 2015 to 2017 and the intervention group treated from 2020 to 2023. Within the control group, 10 cases of HO (5%) were detected. Within the intervention group, 2 cases of HO (1%) were found. The Pearson χ² test with Yates continuity correction produced a value of 4.21, with a P value of .04.

Conclusions

In this study, we found a significantly lower incidence rate of HO in patients who received standardized education on the importance of NSAID compliance versus those who did not. This finding suggests that patient education may play a contributory role in reducing the incidence of HO after hip arthroscopy.