Trevan Klug B.S. , James D. Fox B.B.A. , Raquel Rosa , Nicholas Pettinelli M.S. , Scott Fong B.A. , Soheil Sabzevari M.D. , Michael S. Lee B.A. , Jay Moran M.D. , Nancy Park B.S. , Ronak J. Mahatme B.S. , Stephen M. Gillinov A.B. , Andrew E. Jimenez M.D.
{"title":"在短期随访中，接受门静脉周围和穿刺包膜切开术的患者显示出良好的结果：一项系统回顾。","authors":"Trevan Klug B.S. , James D. Fox B.B.A. , Raquel Rosa , Nicholas Pettinelli M.S. , Scott Fong B.A. , Soheil Sabzevari M.D. , Michael S. Lee B.A. , Jay Moran M.D. , Nancy Park B.S. , Ronak J. Mahatme B.S. , Stephen M. Gillinov A.B. , Andrew E. Jimenez M.D.","doi":"10.1016/j.arthro.2025.01.027","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether patients undergoing primary hip arthroscopy<span> with periportal or puncture capsulotomy demonstrate improved patient-reported outcomes (PROs) at minimum 2-year follow-up when compared with preoperative PROs.</span></div></div><div><h3>Methods</h3><div>A systematic review<span> was performed and registered in PROSPERO under ID: CRD42023466053. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus were searched in October of 2024 using the following string: (capsul∗ OR puncture OR periportal) and (hip OR femoroacetabular impingement) AND (arthroscop∗). Articles were included if they reported preoperative and minimum 2-year follow-up PROs in patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears with periportal or puncture capsulotomy and were written in English.</span></div></div><div><h3>Results</h3><div><span>Six studies were included, with 5 studies reporting outcomes on periportal capsulotomy (313 hips) and 1 study on puncture capsulotomy (163 hips). Three studies were Level IV evidence and 3 were Level III. Study periods ranged from 2013 to 2020. Average improvement in the modified Harris Hip Score ranged from 21.1 to 32.56 (</span><em>I</em><sup>2</sup><span> = 97%). Average improvement in the visual analog scale for pain ranged from −2.5 to −5.3 (</span><em>I</em><sup>2</sup><span><span> = 94%). Minimal clinically important difference<span> was achieved by 65.0% to 100% of patients for Hip Outcome Score – Activities of Daily Living, 71.8% to 88% for Hip Outcome Score-Sport, and 62.5% to 78% for analog scale for pain. Three studies reported rates of secondary </span></span>total hip arthroplasty, ranging from 0% to 1.7%.</span></div></div><div><h3>Conclusions</h3><div>Patients undergoing hip arthroscopy with periportal capsulotomy showed improvements in multiple PROs at a minimum of 2-year follow-up. Periportal capsulotomy appears to be an effective capsulotomy technique in patients undergoing hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Preliminary evidence shows puncture capsulotomy may be an effective way to access the capsule during hip arthroscopy, but conclusions are limited, given the lack of studies available.</div></div><div><h3>Level of Evidence</h3><div>Level IV, systematic review of Level III and IV studies.</div></div>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":"41 9","pages":"Pages 3764-3775.e1"},"PeriodicalIF":5.4000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Patients Undergoing Hip Arthroscopy With Periportal and Puncture Capsulotomy Demonstrate Favorable Outcomes at Short-Term Follow-Up: A Systematic Review\",\"authors\":\"Trevan Klug B.S. , James D. Fox B.B.A. , Raquel Rosa , Nicholas Pettinelli M.S. , Scott Fong B.A. , Soheil Sabzevari M.D. , Michael S. 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Articles were included if they reported preoperative and minimum 2-year follow-up PROs in patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears with periportal or puncture capsulotomy and were written in English.</span></div></div><div><h3>Results</h3><div><span>Six studies were included, with 5 studies reporting outcomes on periportal capsulotomy (313 hips) and 1 study on puncture capsulotomy (163 hips). Three studies were Level IV evidence and 3 were Level III. Study periods ranged from 2013 to 2020. Average improvement in the modified Harris Hip Score ranged from 21.1 to 32.56 (</span><em>I</em><sup>2</sup><span> = 97%). Average improvement in the visual analog scale for pain ranged from −2.5 to −5.3 (</span><em>I</em><sup>2</sup><span><span> = 94%). Minimal clinically important difference<span> was achieved by 65.0% to 100% of patients for Hip Outcome Score – Activities of Daily Living, 71.8% to 88% for Hip Outcome Score-Sport, and 62.5% to 78% for analog scale for pain. Three studies reported rates of secondary </span></span>total hip arthroplasty, ranging from 0% to 1.7%.</span></div></div><div><h3>Conclusions</h3><div>Patients undergoing hip arthroscopy with periportal capsulotomy showed improvements in multiple PROs at a minimum of 2-year follow-up. Periportal capsulotomy appears to be an effective capsulotomy technique in patients undergoing hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. 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引用次数: 0
摘要
目的：评估在至少2年的随访中，与术前的PROs相比，接受门静脉周围髋关节镜或穿刺囊腔切开术的患者是否表现出更好的PROs。方法：进行系统评价并在PROSPERO注册，ID: CRD42023466053。本综述遵循系统评价和荟萃分析首选报告项目（PRISMA）。PubMed、Cochrane Central Register of Controlled Trials （Central）和Scopus于2024年10月检索，使用以下字符串：（capsules * OR穿刺或门静脉周围）和（髋关节或股髋臼撞击）and （arthroscop*）。通过门静脉周围或穿刺包膜切开术治疗股髋臼撞击（FAI）和/或唇部撕裂的患者，如果报道术前和至少2年随访的PROs，并以英文撰写，则纳入文献。结果：纳入6项研究，其中5项研究报告了门静脉周围囊膜切开术（313髋）的结果，1项研究报告了穿刺囊膜切开术（163髋）的结果。三项研究为IV级证据，三项为III级证据。研究期间为2013-2020年。改良Harris髋关节评分（mHHS）的平均改善范围为21.1-32.56 （I2=97%）。视觉模拟疼痛量表（VAS pain）的平均改善范围为-2.5- (-5.3)（I2=94%）。髋部预后评分-日常生活活动（HOS-ADL）的最小临床重要差异（MCID）达到65.0-100%，HOS-Sport达到71.8-88%，VAS疼痛达到62.5-78%。三项研究报告了二次全髋关节置换术（THA）的发生率，范围为0%-1.7%。结论：在至少2年的随访中，接受髋关节镜和门周囊切开术的患者在多个PROs方面有所改善。门静脉周围囊腔切开术似乎是髋关节镜下治疗FAI和/或唇裂的一种有效的囊腔切开术。初步证据显示穿刺囊腔切开术可能是髋关节镜检查时进入囊腔的有效方法，但由于缺乏研究，结论有限。证据等级：IV级，III级和IV级研究的系统评价。
Patients Undergoing Hip Arthroscopy With Periportal and Puncture Capsulotomy Demonstrate Favorable Outcomes at Short-Term Follow-Up: A Systematic Review
Purpose
To evaluate whether patients undergoing primary hip arthroscopy with periportal or puncture capsulotomy demonstrate improved patient-reported outcomes (PROs) at minimum 2-year follow-up when compared with preoperative PROs.
Methods
A systematic review was performed and registered in PROSPERO under ID: CRD42023466053. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus were searched in October of 2024 using the following string: (capsul∗ OR puncture OR periportal) and (hip OR femoroacetabular impingement) AND (arthroscop∗). Articles were included if they reported preoperative and minimum 2-year follow-up PROs in patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears with periportal or puncture capsulotomy and were written in English.
Results
Six studies were included, with 5 studies reporting outcomes on periportal capsulotomy (313 hips) and 1 study on puncture capsulotomy (163 hips). Three studies were Level IV evidence and 3 were Level III. Study periods ranged from 2013 to 2020. Average improvement in the modified Harris Hip Score ranged from 21.1 to 32.56 (I2 = 97%). Average improvement in the visual analog scale for pain ranged from −2.5 to −5.3 (I2 = 94%). Minimal clinically important difference was achieved by 65.0% to 100% of patients for Hip Outcome Score – Activities of Daily Living, 71.8% to 88% for Hip Outcome Score-Sport, and 62.5% to 78% for analog scale for pain. Three studies reported rates of secondary total hip arthroplasty, ranging from 0% to 1.7%.
Conclusions
Patients undergoing hip arthroscopy with periportal capsulotomy showed improvements in multiple PROs at a minimum of 2-year follow-up. Periportal capsulotomy appears to be an effective capsulotomy technique in patients undergoing hip arthroscopy for the treatment of femoroacetabular impingement and/or labral tears. Preliminary evidence shows puncture capsulotomy may be an effective way to access the capsule during hip arthroscopy, but conclusions are limited, given the lack of studies available.
Level of Evidence
Level IV, systematic review of Level III and IV studies.
期刊介绍：
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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