原发性髋关节镜检查后 5 年,磁共振成像显示 81% 未修复的关节囊间切开术已痊愈

Onur Hapa M.D. , Selahaddin Aydemir M.D , Asli Irmak Akdogan M.D , Mustafa Celtik M.D , Ozgur Aydin M.D , Batuhan Gocer M.D , Onur Gursan M.D
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引用次数: 0

摘要

目的 评估初次髋关节镜手术后5年,未修复的关节囊间切开术是否会在磁共振成像(MRI)上显示关节囊缺损,并确定其对功能结果以及X光片或MRI扫描发现的骨关节炎的影响。方法 回顾性分析股骨髋臼撞击症患者(无关节炎或发育不良)在关节镜下通过未闭合的关节囊间切开术进行唇修补术或清创术和股骨成形术后的情况。使用患者报告的结果(髋关节结果评分-日常生活活动量表、改良哈里斯髋关节评分和视觉模拟评分表疼痛评分)、放射学测量和核磁共振扫描对患者进行术前和术后至少5年的评估。其中,81%的患者髋关节囊已愈合,8 例(19%)患者在最近一次核磁共振扫描中发现髋关节囊缺损。在最新的磁共振成像扫描中,囊缺损组有 3 个髋关节出现软骨下水肿,而囊愈合组仅有 1 个(P = 0.01),术前磁共振成像中并没有出现软骨下水肿(如果将术前α角也考虑在内,多变量分析结果仍为阳性)。结论在这项研究中,81% 的关节间囊切口在初次髋关节镜手术后 5 年愈合,未进行修补。临床意义了解未愈合关节间囊切口的发生率和影响可以鼓励外科医生在闭合关节囊时一丝不苟。
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Eighty-One Percent of Unrepaired Interportal Capsulotomies Showed Healed Capsules on Magnetic Resonance Imaging 5 Years After Primary Hip Arthroscopy

Purpose

To evaluate whether unrepaired interportal capsulotomy presents with capsular defect on magnetic resonance imaging (MRI) 5 years after primary hip arthroscopy and to determine its effect on functional results and findings of osteoarthritis on radiographs or MRI scans.

Methods

Patients with femoroacetabular impingement (without arthritis or dysplasia) were retrospectively reviewed after arthroscopic labral repair or debridement and femoroplasty through interportal capsulotomy without closure. Patients were assessed preoperatively and at a minimum of 5 years postoperatively using patient-reported outcomes (Hip Outcome Score–Activities of Daily Living scale, modified Harris Hip Score, and visual analog scale pain score), radiographic measures, and MRI scans.

Results

Forty patients (42 hips) were deemed eligible for the study and were evaluated. Of the hips, 81% had healed capsules, whereas 8 (19%) had capsular defects on the latest MRI scan. There were 3 hips with subchondral edema in the defect group compared with 1 in the healed-capsule group (P = .01) on the latest MRI scan, which was not present on preoperative MRI (still positive on multivariate analysis when the preoperative alpha angle was also taken into consideration). Functional results did not differ between the groups (P > .05).

Conclusions

In this study, 81% of interportal capsulotomies healed without repair at 5 years after primary hip arthroscopy.

Clinical Relevance

Understanding the prevalence and implications of unhealed capsulotomies could encourage surgeons to be meticulous in capsular closure.

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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
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