Inside-out和Outside-in髋关节镜技术治疗股骨髋臼撞击征的疗效对比研究
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钟名金 ZHONG Ming-jin 深圳大学第一附属医院 深圳市第二人民医院运动医学科, 广东 深圳 518000 Department of Sports Medicine, the Second People's Hospital of Shenzhen University, Shenzhen 518000, Guangdong, China  
欧阳侃 OUYANG Kan 深圳大学第一附属医院 深圳市第二人民医院运动医学科, 广东 深圳 518000 Department of Sports Medicine, the Second People's Hospital of Shenzhen University, Shenzhen 518000, Guangdong, China 510296924@qq.com 
彭亮权 PENG Liang-quan 深圳大学第一附属医院 深圳市第二人民医院运动医学科, 广东 深圳 518000 Department of Sports Medicine, the Second People's Hospital of Shenzhen University, Shenzhen 518000, Guangdong, China  
陈康 CHEN Kang 深圳大学第一附属医院 深圳市第二人民医院运动医学科, 广东 深圳 518000 Department of Sports Medicine, the Second People's Hospital of Shenzhen University, Shenzhen 518000, Guangdong, China  
柳海峰 LIU Hai-feng 深圳大学第一附属医院 深圳市第二人民医院运动医学科, 广东 深圳 518000 Department of Sports Medicine, the Second People's Hospital of Shenzhen University, Shenzhen 518000, Guangdong, China  
邓桢翰 DENG Zhen-han 深圳大学第一附属医院 深圳市第二人民医院运动医学科, 广东 深圳 518000 Department of Sports Medicine, the Second People's Hospital of Shenzhen University, Shenzhen 518000, Guangdong, China  
朱伟民 ZHU Wei-min 深圳大学第一附属医院 深圳市第二人民医院运动医学科, 广东 深圳 518000 Department of Sports Medicine, the Second People's Hospital of Shenzhen University, Shenzhen 518000, Guangdong, China  
陆伟 LU Wei 深圳大学第一附属医院 深圳市第二人民医院运动医学科, 广东 深圳 518000 Department of Sports Medicine, the Second People's Hospital of Shenzhen University, Shenzhen 518000, Guangdong, China  
期刊信息:《中国骨伤》2021年,第34卷,第12期,第1141-1146页
DOI:10.12200/j.issn.1003-0034.2021.12.010
基金项目:广东省医学科学技术研究基金项目(编号:A2018284);深圳市第二人民医院临床研究项目(编号:20193357019)
中文摘要:

目的:对比分析两种髋关节镜技术治疗股骨髋臼撞击征(femoroacetabular impingement,FAI)的临床疗效和并发症。

方法:回顾性分析2016年6月至2019年6月采用髋关节镜手术治疗并获得随访的48例FAI患者。根据手术方式的不同分为两组,Inside-out组,由中央到外周;Outside-in组,由外周到中央。Inside-out组24例,男14例,女10例,年龄(39.8±7.6)岁;Outside-in组24例,男13例,女11例,年龄(39.5±9.1)岁。两组患者年龄、性别、体质量指数、侧别、撞击类型、病程、随访时间比较差异无统计学意义。对两组术后髋关节改良Harris (modified Harris hip score,mHHS),非骨关节炎髋关节(nonarthritic hip score,NAHS)评分和术后并发症发生率进行比较。

结果:两组患者术后髋关节功能评分mHHS和NAHS评分均较术前提高,但组间比较差异无统计学意义(P>0.05)。Inside-out组术后4例出现神经牵拉伤,3例医源性损伤;而Outside-in组仅1例神经牵拉伤。Inside-out组并发症发生率高于Outside-in组(16.7% vs 4.2%,χ2=5.400,P=0.020)。

结论:Inside-out和Outside-in两种髋关节镜技术治疗FAI均可取得良好的临床效果,但相对于Inside-out技术,Outside-in技术术后并发症发生率低,针对符合适应证的患者可以优先选择。
【关键词】髋关节  股骨髋臼撞击征  临床疗效  关节镜技术
 
Clinical outcomes of hip arthroscopic treatment for femoroacetabular impingement: a comparative study between Inside-out and Outside-in approach
ABSTRACT  

Objective: To compare the clinical outcomes and complications of hip arthroscopic treatment for femoroacetabular impingement (FAI) performed with either Inside-out or Outside-in approach.

Methods: The clinical date of 48 patients with FAI treated by hip arthroscopy surgery and follow-up from June 2016 to June 2019 were retrospectively analyzed. According to the different operative methods,the patients were divided into two groups. Inside-out group,from central compartment to peripheral compartment;Outside-in group,from peripheral compartment to central compartment. There were 14 males and 10 females in Inside-out group with an average age of (39.8±7.6)years old,13 males and 11 females in Inside-out group with an average age of (39.5±9.1)years old in Outside-in group. There was no significant difference in age,gender,body mass index,side,impingement type,medical history and follow-up time between the two groups. The complication occurrence rate,modified Harris hip score(mHHS)and nonarthritic hip score(NAHS) were compared between these two groups.

Results: The mHHs and NAHS scores of the two groups were significantly higher than those before operation,but there was no significant difference between the two groups(P>0.05). In the Inside-out group,there were 4 cases of nerve traction injury and 3 cases of iatrogenic injury,while only 1 case of nerve traction injury occurred in the Outside-in group. The incidence of complications in the inside out group was higher than that in the outside in group(16.7% vs 4.2%, χ2=5.400,P=0.020).

Conclusion: Both hip arthroscopic surgery methods can obtain satisfactory clinical efficacy in the treatment of FAI,but the incidence of postoperative complications of Outside-in surgical method is lower. The out-side in method can be preferentially selected for the patients with the indications of operation.
KEY WORDS  Hip joint  Femoroacetabular impingement  Clinical outcomes  Arthroscopic technique
 
引用本文,请按以下格式著录参考文献:
中文格式:钟名金,欧阳侃,彭亮权,陈康,柳海峰,邓桢翰,朱伟民,陆伟.Inside-out和Outside-in髋关节镜技术治疗股骨髋臼撞击征的疗效对比研究[J].中国骨伤,2021,34(12):1141~1146
英文格式:ZHONG Ming-jin,OUYANG Kan,PENG Liang-quan,CHEN Kang,LIU Hai-feng,DENG Zhen-han,ZHU Wei-min,LU Wei.Clinical outcomes of hip arthroscopic treatment for femoroacetabular impingement: a comparative study between Inside-out and Outside-in approach[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(12):1141~1146
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