摘要
目的探讨髋关节镜下治疗髋臼股骨撞击症(femoroacetabular impingement,FAI)合并盂唇损伤的临床疗效。方法回顾性分析2016年2月至2020年5月厦门市海沧医院采用髋关节镜下治疗FAI合并盂唇损伤的34例病人的临床资料。收集并比较术前及术后末次随访的髋关节屈曲、内收、屈髋90°内旋活动度,疼痛视觉模拟量表(visual analogue scale,VAS)评分,改良Harris髋关节功能评分。结果所有病人伤口均甲级愈合,术后2例会阴部麻木,1例患足麻木,1周后症状消失;1例股外侧皮神经损伤后大腿前外侧麻木,经过营养神经治疗1个月后恢复正常;随访(18.0±5.8)个月(12~36个月),32例病人(94.1%)对手术效果表示满意;病人术后末次随访的髋关节屈曲、内收和屈曲90°内旋角度、VAS评分及改良Harris髋关节功能评分与术前比较,差异均有统计学意义(P均<0.05)。所有病人均无伤口感染、血管损伤、异位骨化、股骨颈骨折、坐骨神经损伤、股神经损伤、髋关节不稳定或髋关节脱位等严重并发症发生。随访期间,未见髋关节骨关节炎进展,无需二次行髋关节镜下翻修手术。结论在严格把握手术指征、加强并发症防范意识,努力提高手术技术的前提下,髋关节镜下治疗FAI合并盂唇损伤,能够有效缓解病人症状,改善髋关节活动功能,是一种安全、微创、疗效确切的手术方法。
Objective To evaluate the clinical efficacy of hip arthroscopy in the treatment of femoroacetabular impingement(FAI) combined with labrum injury.Methods A retrospective analysis was performed on the clinical data of 34 patients who underwent hip arthroscopy for the treatment of FAI with labral injury in Xiamen Haicang Hospital from February 2016 to May 2020.The hip flexion,adduction,and hip 90°internal rotation activity,visual analogue scale(VAS) pain scores,and modified Harris hip function scores preoperation and at the last follow-up postoperation were collected and compared.Results The incision of all patients healed well.There were 2 cases of numbness of the perineal region and one case of numbness of the feet after operation.The symptoms disappeared within one week.There was one case of numbness of the thigh anterior and lateral numbness after injury of the lateral femoral cutaneous nerve.The symptoms disappeared after one month with neurotrophic drug treatment.All patients were followed up for(18.0±5.8) months(mean 12-36 months).Total of 32 patients(94.1%) expressed satisfaction with the results of the operation.The patient’s hip flexion,adduction and flexion 900 internal rotation angle at the last follow-up postoperation,VAS scores and modified Harris hip joint function scores were compared with those before surgery and the differences were statistically significant(all P <0.05).All patients had no serious complications such as wound infection,vascular injury heterotopic ossification,femoral neck fracture,sciatic nerve injury,femoral nerve injury hip instability or hip dislocation.During the follow-up period,no progression of osteoarthritis of the hip joint was seen,and no patient needed a second hip arthroscopy revision operation.Conclusion Under the premise of strictly grasping the indications of surgery,strengthening the awareness of prevention of complications,and striving to improve the surgical techniques,the hip arthroscopy can effectively relieve the symptoms of patients and improve the hip functions in the treatment of FAI combined with labrum injury.It is a safe,minimally invasive and effective surgical method.
作者
陈忠益
曾国庆
黄建军
张晋
王雪松
CHEN Zhong-yi;ZENG Guo-qing;HUANG Jian-jun;ZHANG Jin;WANG Xue-song(Department of Orthopaedics,Xiamen Haicang Hospital,Xiamen 361026,China;Department of Sports Medicine Service,Beijing Jishuitan Hospital,Beijing 100035,China)
出处
《骨科》
CAS
2020年第6期535-540,共6页
ORTHOPAEDICS
关键词
髋关节镜
髋臼股骨撞击症
盂唇损伤
关节囊修补
并发症
Hip arthroscopy
Femoroacetabular impingement
Labrum injury
Joint capsule repair
Complications
作者简介
通信作者:陈忠益,E⁃mail:josephtan998@163.com。
