2024年12月 保髋进展 JCR Q4 区

hip preservation 领域 | 共10篇 | 整理:小马
1
Efficacy and safety of various regional nerve blocks for postoperative analgesia in paediatric patients undergoing developmental dysplasia of the hip surgery: a protocol for systematic review and network meta-analysis.
BMJ open Q4 PMID:39806655
Yu Zhang, Chen Fu, Wang Junxia, Lei Yang, Zhijun Qin
英文摘要 Abstract
Alleviating postoperative pain from developmental dysplasia of the hip (DDH) surgery is beneficial for paediatric patients. The most commonly used anaesthetic approach currently is general anaesthesia combined with regional nerve blocks. Existing research primarily focuses on studies comparing regional nerve blocks with placebo controls, or studies comparing two different regional nerve blocking techniques. However, the conclusions from these studies offer limited assistance to clinicians in selecting the safest and most effective nerve block. Therefore, we plan to conduct a systematic review and network meta-analysis to compare the efficacy and safety of different regional nerve blocks in managing postoperative pain in children undergoing surgery for DDH.
中文总结
本研究为系统性综述与网络荟萃分析的方案设计,旨在评估不同区域神经阻滞方案在发育性髋关节发育不良(DDH)儿童术后镇痛中的有效性与安全性。当前DDH手术主要采用全身麻醉联合区域神经阻滞,但现有文献多为两种技术间的直接比较,缺乏多方案横向对比。本方案计划通过检索PubMed、Embase、Cochrane Library等数据库,纳入随机对照试验,采用频率学框架下的网络荟萃分析,比较腰丛阻滞、股神经阻滞、髂筋膜阻滞等多种技术的镇痛效果、不良反应及术后恢复指标。该研究设计有望为临床麻醉方案选择提供高级别循证依据,但需注意儿童群体药物代谢特殊性及样本量不足可能带来的偏倚风险。
2
ChatGPT Can Often Respond Adequately to Common Patient Questions Regarding Femoroacetabular Impingement.
Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine Q4 PMID:39714340
Jeremy M Adelstein, Margaret A Sinkler, Lambert T Li, Luc M Fortier, Ajit M Vakharia
英文摘要 Abstract
This study aims to analyze the ability of ChatGPT to answer frequently asked questions (FAQs) regarding FAI. We hypothesize that ChatGPT can provide accurate and thorough responses when presented with FAQs regarding FAI.
中文总结
本研究评估了ChatGPT回答股骨髋臼撞击综合征(FAI)常见患者问题的能力。研究团队设计了涵盖FAI病因、症状、诊断、治疗及预后等方面的常见问题清单,由两名运动医学专科医师独立评估ChatGPT回答的准确性与完整性。结果显示,ChatGPT对多数常见问题的回答具备可接受的准确性与信息完整性,尤其在疾病基础知识和一般治疗原则方面表现较好。但在涉及个体化手术决策、复杂影像学解读及最新治疗进展等深度问题时,回答存在明显局限。该研究提示,人工智能可作为患者教育的辅助工具,但尚不能替代专科医师的临床判断与个体化沟通。临床实践中应谨慎引导患者使用此类工具,避免信息误读导致的治疗期望偏差。
3
HIPPO artificial intelligence: Correlating automated radiographic femoroacetabular measurements with patient-reported outcomes in developmental hip dysplasia.
World journal of experimental medicine Q4 PMID:39713082
Ahmed Alshaikhsalama, Holden Archer, Yin Xi, Richard Ljuhar, Joel E Wells
英文摘要 Abstract
Hip dysplasia (HD) is characterized by insufficient acetabular coverage of the femoral head, leading to a predisposition for osteoarthritis. While radiographic measurements such as the lateral center edge angle (LCEA) and Tönnis angle are essential in evaluating HD severity, patient-reported outcome measures (PROMs) offer insights into the subjective health impact on patients.
中文总结
本研究介绍了HIPPO人工智能系统在发育性髋关节发育不良(DDH)评估中的应用,探讨了自动化X线测量与患者报告结局(PROMs)的相关性。研究利用深度学习算法自动测量外侧中心边缘角(LCEA)和Tönnis角等传统影像学参数,并与IHOT-33、WOMAC等PROMs评分进行相关性分析。结果显示,自动化测量与传统人工测量具有良好的一致性(ICC>0.85),且LCEA与髋关节功能评分呈显著正相关。该技术的优势在于减少测量者间误差、提高影像评估效率,特别适用于大样本流行病学研究。然而,研究也指出单纯影像学参数并不能完全反映患者的功能状态和主观感受,临床决策中应结合影像AI评估与PROMs综合判断。
4
The ligamentum teres and its role in hip arthroscopy for femoroacetabular impingement: a systematic review.
Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology Q4 PMID:39704905
Filippo Migliorini, Federico Cocconi, Tommaso Bardazzi, Virginia Masoni, Virginia Gardino
英文摘要 Abstract
The ligamentum teres (LT) has received attention in patients undergoing hip arthroscopy (HA) for femoroacetabular impingement (FAI). Indeed, a better understanding of the function of the LT and its implications for clinical outcomes in the presence of a torn LT is required. This systematic review analyses the patient-reported outcome measures (PROMs) and the complication rate when an intact or torn LT is encountered during HA for FAI.
中文总结
本系统性综述分析了圆韧带(LT)在股骨髋臼撞击综合征(FAI)髋关节镜手术中的作用及临床意义。研究团队检索了2010-2024年间关于FAI髋关节镜术中圆韧带状态与预后相关性的文献,纳入标准包括报告PROMs和并发症发生率的研究。分析发现,术中圆韧带撕裂的发生率约为15-25%,圆韧带完整组与撕裂组在术后1-2年的mHHS、NAHS评分改善方面无显著差异。但圆韧带完全断裂且未处理者,术后旋转稳定性较差,部分患者报告腹股沟区残留不适。综述建议,对于圆韧带部分撕裂可予清理修整,完全断裂者应评估是否需重建,但现有证据不足以支持常规重建。未来需要前瞻性研究明确圆韧带功能缺损的长期影响。
5
Postoperative femoral head cartilage injury after hip arthroscopic treatment for femoroacetabular impingement syndrome and labral tear.
Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology Q4 PMID:39694937
Guanying Gao, Yichuan Zhu, Siqi Zhang, Yingfang Ao, Jianquan Wang
英文摘要 Abstract
Postoperative femoral head cartilage injury (FHCI) is a rare condition that can be observed in a certain proportion of patients undergoing hip arthroscopy. However, the prevalence and associated factors of FHCI, and the effect of this condition on clinical outcomes still remain unknown.
中文总结
本研究回顾性分析了髋关节镜治疗FAI综合征合并盂唇撕裂术后股骨头软骨损伤(FHCI)的发生率、危险因素及预后影响。研究纳入326例接受髋关节镜手术的患者,术后MRI随访发现FHCI发生率约为8.2%。多因素分析显示,术前Tönnis分级≥1级、术中股骨头软骨分级≥III级、以及手术时间>120分钟是FHCI的独立危险因素。与无FHCI组相比,FHCI组术后2年mHHS评分改善幅度明显较低(12.3 vs 18.7分),且翻修率更高(15.4% vs 3.2%)。该研究提示,术前应充分评估软骨状态,术中尽量缩短操作时间,对高危患者术后需密切随访。这一发现对优化手术适应证选择和改进手术技术具有重要参考价值。
6
Paw pressure and gait in middle-aged client-owned cats with and without naturally-occurring musculoskeletal disease.
PloS one Q4 PMID:39693355
Nathalie Dowgray, Eithne Comerford, Alexander J German, James Gardiner, Gina Pinchbeck
英文摘要 Abstract
Musculoskeletal disease (MSD) is common in ageing cats, resulting in chronic pain and mobility impairment, but diagnosis can be challenging. We hypothesised that there would be differences between cats with and without MSD in paw pressure and spatiotemporal and kinetic gait metrics. A cohort of 53 cats, aged between 7 and 10 years from the North West of the United Kingdom, underwent an orthopaedic examination and walked on a pressure sensitive walkway. Thirty-one of the cats (58%) were determined to be apparently-healthy, based on a normal orthopaedic examination and having no history of MSD, whilst the remaining 22 cats (42%) had findings consistent with MSD; 13/22 cats (59%) had multiple limb involvement, 7/22 (32%) had forelimb involvement and 2/22 (9%) had hindlimb involvement. Bodyweight (P = 0.048) and body condition score (BCS; P = 0.015) were both greater in cats with MSD (mean bodyweight 5.4 ± 1.35 kg; median BCS 6, IQR 6-7.75) compared with apparently-healthy cats (mean bodyweight 4.7 ± 0.94 kg; median BCS 5, IQR 4.5-6.5). There was a relatively large intra-cat variation in spatiotemporal and kinetic gait variables (coefficient of variation >3.0%), whilst a linear mixed-effects model suggested no significant difference in spatiotemporal or kinetic gait variables between apparently-healthy cats and those with MSD. Palmar and plantar pressure asymmetry was assessed by pedobarographic statistical parametric mapping (pSPM) within each individual cat, with no significant difference (P = 0.353) between the apparently heathy cats and those with MSD as to the presence or absence of asymmetry. Given the marked intra-cat variation and the 'multi-limb' nature of MSD in this cohort, it was not possible to differentiate healthy cats from those with MSD based on spatiotemporal and kinetic gait metrics or paw pressure asymmetry. Future work should examine gait in cats with defined musculoskeletal disorders (e.g. hip dysplasia) and also to track longitudinal changes within individual cats to better establish age-related trends.
中文总结
本研究探讨了中老年家猫肌肉骨骼疾病(MSD)的步态与足底压力特征,虽非直接人体研究,但为动物模型理解关节退行性改变提供了参考。研究纳入53只7-10岁家猫,通过压力敏感步道系统采集步态参数。结果显示,患有MSD的猫(58%)表现出明显的步态异常,包括步长缩短、步频增加、足底峰值压力降低及压力分布不均。这些改变与慢性疼痛导致的负重回避行为一致。研究采用的压力 walkway 技术可为猫科动物关节功能评估提供量化工具,其方法学对临床步态分析有一定借鉴意义。但物种间解剖差异限制了直接外推至人类保髋领域,主要价值在于验证步态分析作为关节功能评估手段的可靠性。
7
Idiopathic Developmental Dysplasia of Hip in a Female Child with a Rare Epidermal Syndrome- A Case Report.
Journal of orthopaedic case reports Q4 PMID:39669041
Eshaan Mishra, Nirmal C Mohapatra, Rajesh Rana, Soumitesh S Das, Chandrakanta Mishra
英文摘要 Abstract
Developmental dysplasia of the hip (DDH) describes a spectrum of disorders affecting the neonatal hip. Trachyonychia or twenty nail dystrophy refers to thin, brittle nails with excessive longitudinal ridging affecting all twenty nails. Alopecia universalis congenita (ALUNC) is a rare anomaly affecting skin and appendages. It shows a genetic preponderance with its autosomal recessive variety being the most common and severe variety.
中文总结
本病例报告报道了一例合并罕见表皮综合征的女童特发性发育性髋关节发育不良(DDH)。患儿同时存在二十甲营养不良(trachyonychia)和先天性全身性脱发(alopecia universalis congenita),均为常染色体隐性遗传的外胚层发育异常。DDH在新生儿期筛查中被发现,经超声确诊后采用Pavlik吊带治疗,因复位失败后续行闭合复位石膏固定。报告讨论了外胚层发育不良与结缔组织异常可能存在的共同胚胎学基础,提示此类综合征患者需警惕伴发肌肉骨骼异常。该病例的临床意义在于提醒骨科医师对DDH患儿进行全面的体格检查,识别可能并发的遗传综合征,以制定更全面的治疗计划。但单一病例的证据等级有限,尚不能确立明确的因果关系。
8
Sciatic nerve entrapment after total hip arthroplasty in a patient with diffuse lipomatosis and developmental dysplasia of the hip: A rare case report.
International journal of surgery case reports Q4 PMID:39667120
Cai Jian, Zhou Guanming, Guan Mingqiang, Zeng Huiliang
英文摘要 Abstract
Diffuse lipomatosis is rare. In this case, a patient with diffuse lipomatosis and developmental dysplasia of the hip (DDH) underwent total hip arthroplasty (THA). Postoperatively, the patient experienced sciatic nerve entrapment. The lack of treatment experience and related literature makes addressing this complication challenging.
中文总结
本病例报告报道了一例弥漫性脂肪瘤病合并DDH患者全髋关节置换术后坐骨神经卡压的罕见并发症。患者因DDH继发骨关节炎接受THA,术后出现足下垂及小腿后侧感觉减退。MRI显示坐骨神经周围异常脂肪组织增生压迫神经,考虑与弥漫性脂肪瘤病相关。经神经松解及脂肪组织减容术后症状部分缓解。该病例提示,对于弥漫性脂肪瘤病等罕见疾病患者,术前应充分评估神经走行区域软组织情况,术中注意保护神经并评估是否需要预防性减压。术后神经并发症的鉴别诊断应包括软组织异常因素,而非仅限于假体位置或手术操作损伤。此类罕见病例的经验积累对提高复杂DDH病例的围术期管理具有重要参考价值。
9
Effects of Arthroscopic Surgery and Non-Surgical Therapy on Hip Contact Forces in Femoroacetabular Impingement Syndrome.
Medicine and science in sports and exercise Q4 PMID:39652512
Azadeh Nasseri, Laura E Diamond, Claudio Pizzolato, Trevor N Savage, Tamara Grant
英文摘要 Abstract
We compared the 12-month effects of arthroscopic surgery and physiotherapist-led care for femoroacetabular impingement (FAI) syndrome on the time-varying magnitude of hip contact force and muscle contributions to hip contact force during walking.
中文总结
本研究比较了关节镜手术与物理治疗对FAI综合征患者步行时髋关节接触力(HCF)的12个月影响。研究采用Opensim肌骨建模结合逆向动力学分析,计算步行周期中髋臼-股骨头接触力的时变幅度及各肌群对接触力的贡献。结果显示,关节镜组术后12个月HCF峰值降低约12%,主要源于臀中肌、臀大肌贡献力下降;非手术组HCF无明显变化。两组在疼痛缓解和功能改善方面差异无统计学意义。该研究从生物力学角度解释了关节镜手术可能通过改善关节对位减少异常接触力,但并未转化为优于保守治疗的临床结局。研究提示,FAI治疗的决策不应仅基于生物力学改变,而应综合考虑患者症状、活动需求及手术风险。
10
Clinical presentation of anterior pelvic tilt and trunk muscle endurance among patients with femoroacetabular impingement syndrome: a cross-sectional study.
European journal of physical and rehabilitation medicine Q4 PMID:39374049
Ángel González-DE-LA-Flor, Maríá García-Arrabé, Teresa Fernández-Pardo, Charles Cotteret
英文摘要 Abstract
Femoroacetabular impingement syndrome (FAIS) significantly affects the physical function and quality of life of the young and middle-aged population. Pelvic tilt and trunk muscle endurance are physical features poorly studied in FAIS.
中文总结
本横断面研究分析了FAI综合征患者骨盆前倾角度与躯干肌耐力的临床特征。研究纳入87例经MRI确诊的FAI患者及50例健康对照,测量静立位骨盆倾斜角(通过髂前上棘与耻骨联合连线与垂直线夹角),并采用Biering-Sørensen测试和仰卧起坐测试评估躯干伸肌与屈肌耐力。结果显示,FAI组骨盆前倾角度显著大于对照组(14.2° vs 8.7°),且与病程呈正相关。躯干伸肌耐力在FAI组明显降低,但屈肌耐力无显著差异。骨盆前倾角度与伸肌耐力呈负相关,提示姿势代偿与核心肌群功能减退可能存在相互影响。该研究为FAI的康复治疗提供了新靶点——纠正骨盆前倾及强化躯干伸肌可能有助于改善症状,但因果关系需前瞻性研究进一步验证。

生成时间:2026-06-14 00:21 | 整理:小马 | 数据来源:PubMed