英文摘要 Abstract
BACKGROUND: Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic condition. Caregivers of children with DDH often face significant challenges that may affect their quality of life. This review aimed to systematically identify, appraise, summarize the available qualitative evidence on caregivers' experiences of caring for children with DDH.
METHODS: We systematically searched eight databases (Embase, Cochrane Library, Web of Science, PubMed, CINAHL, PsycINFO, ERIC, and ProQuest) from inception to May 2025. Two researchers independent screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A meta-aggregative approach was used to categorize and summarize themes reported in the primary studies. Confidence in each summary finding was assessed using GRADE-CERQual.
RESULTS: Eight studies met the inclusion criteria. These included four interview-based studies (total 66 participants) and four survey-based studies with open-ended questions (total 1,522 participants). Four main themes were identified: (1) a challenging and often delayed diagnostic process; (2) treatment devices complicate daily parenting tasks; (3) inadequate or ill-timed informational and practical support; and (4) gradual adaptation and skill development over time.
CONCLUSION: Caregivers of children with DDH face substantial challenges during diagnosis, treatment, and daily care. The findings highlight the potential value of timely, practical, and empathetic support that addresses informational needs and acknowledges the adaptive work families undertake. Future research should employ more in-depth qualitative designs to capture the nuanced processes of caregiver adaptation.
中文总结
本研究系统性地综述了髋关节发育不良患儿照护者的照护体验。通过检索八个数据库并严格筛选，最终纳入8项研究，包括4项访谈研究和4项含开放式问题的调查问卷研究，共涉及1588名参与者。研究归纳出四大主题：诊断过程面临挑战且常被延误；治疗器械使日常育儿任务复杂化；信息与实际支持不足且时机不当；照护者随时间推移逐渐适应并发展出照护技能。该综述表明，DDH患儿照护者在诊断、治疗及日常照护各阶段均承受重大压力，提示及时的、实用且富同理心的支持干预具有潜在价值，同时强调了未来研究应采用更深入的定性设计以捕捉照护者适应过程的细微之处。
英文摘要 Abstract
Developmental dysplasia of the hip (DDH) associated with an acute proximal femoral fracture on the same side is uncommon, and performing a one-stage total hip arthroplasty (THA) with concurrent fracture stabilization in such cases poses significant technical challenges. We present a case involving a 57-year-old female with a long history of right-sided DDH who was involved in a vehicular accident, leading to acute pain in her right hip, shortening of the limb, and restricted movement. Imaging studies indicated Hartofilakidis type II DDH along with a comminuted intertrochanteric fracture of the proximal femur and a pseudoacetabulum. Utilizing thin-slice computed tomography, we created a customized three-dimensional (3D) printed model of the pelvis and proximal femur, which allowed for detailed preoperative planning. This included evaluating the acetabular bone quality, identifying the true center of the acetabulum, selecting the appropriate cup size and orientation, and strategizing the femoral osteotomy and fixation with plates and cables. A one-stage cementless THA was executed through a posterolateral approach, featuring a small hemispherical cup securely placed in the true acetabulum and a size-16 biological femoral stem anchored distally across the fracture site, followed by the application of a lateral plate and titanium cable to stabilize the proximal femoral fracture. The patient began ambulation with the assistance of a walker on postoperative day 1. At 2 months after surgery, the pain score had decreased to 1/10 on the visual analog scale (VAS), and radiographic evaluation demonstrated ongoing fracture healing. By 3 months postoperatively, the patient was pain-free (VAS 0/10), had achieved a Harris Hip Score of 92, and showed restoration of lower-limb length. Imaging confirmed fracture union and stable prosthesis positioning, and the patient had returned to work independently. This case suggests that individualized 3D printing-assisted preoperative planning may improve the feasibility and early safety of one-stage cementless total hip arthroplasty combined with internal fixation for adult DDH with an ipsilateral proximal femoral fracture, and may provide a useful reference for preoperative decision-making in similarly complex cases.
中文总结
本研究报道了一例采用3D打印技术辅助进行一期全髋关节置换术治疗急性股骨近端骨折合并Hartofilakidis II型髋关节发育不良的病例。患者为57岁女性，因车祸导致右髋急性疼痛、下肢短缩及活动受限。影像学检查证实存在Hartofilakidis II型DDH伴股骨转子间粉碎性骨折及假髋臼形成。研究团队利用薄层CT数据构建了个性化3D骨盆及股骨近端模型，完成了详尽的术前规划，包括评估髋臼骨质量、确定真髋臼中心、选择假体型号与方向，以及制定股骨截骨与内固定策略。手术经后外侧入路完成，一期植入无骨水泥型假体，髋臼杯精准植入真髋臼，股骨柄跨骨折固定，随后以侧板和钛缆固定近端骨折。术后第1天患者即可在助行器辅助下负重行走；2个月时疼痛评分降至1/10，影像学显示骨折愈合中；3个月时疼痛完全缓解，Harris评分达92分，双下肢长度恢复对称，骨折愈合且假体位置良好，患者已恢复正常工作。该病例表明个性化3D打印辅助的术前规划能够显著提高复杂DDH合并骨折的全髋关节置换术的精准性与临床疗效。
英文摘要 Abstract
BACKGROUND: Computed tomography (CT)-based, artificial intelligence (AI)-assisted three-dimensional (3D) preoperative planning is increasingly used to standardize component sizing and positioning in total hip arthroplasty (THA). In complex secondary hip osteoarthritis (HOA), perioperative burden and early recovery are particularly relevant to older or medically complex patients, yet it remains unclear whether etiology still shapes these outcomes under a unified planning pathway and single implant system.
METHODS: This single-center retrospective cohort analyzed 95 consecutive cementless primary THAs for developmental dysplasia of the hip-associated HOA (DDH-HOA,
RESULTS: Planning performance was comparable (cup match 59.62% vs. 65.12%; stem match 61.54% vs. 67.44%), with similar Lewinnek/Callanan safe-zone attainment and a median leg-length discrepancy (LLD) of 1 mm in both groups. Intraoperative blood loss was lower in DDH-HOA than in post-septic HOA (212.69 ± 62.31 vs. 243.72 ± 58.64 mL,
CONCLUSION: Under a unified CT-based AI-assisted 3D planning pathway and single cementless system, sizing concordance and radiographic target attainment were similarly high across etiologies. By 24 months, PROMs were broadly comparable between groups. Post-septic sequelae were associated with greater intraoperative blood loss and less favorable pain and function at 1 month, supporting etiology-informed counseling and targeted perioperative risk mitigation.
中文总结
本研究探讨了在统一的人工智能辅助三维术前规划路径及单一假体系统下，髋关节发育不良相关骨关节炎与感染后遗症相关骨关节炎患者接受全髋关节置换术的病因特异性围手术期结果及早期功能恢复差异。研究纳入95例连续患者进行回顾性分析，结果显示两组间假体匹配率及Lewinnek/Callanan安全区达标率相近，腿长差异中位数均为1毫米。感染后遗症组术中失血量显著高于DDH组，术后1个月疼痛及功能评分均较低，提示感染后遗症患者可能面临更大的围手术期风险。尽管两组在24个月患者报告结局指标方面总体相当，但病因学特征对围手术期管理和早期康复仍具有重要影响，研究支持在术前咨询中应针对不同病因进行个体化风险评估与针对性围手术期管理策略的制定。
英文摘要 Abstract
BACKGROUND: During arthroscopic labral repair, anchors are inserted into the acetabular rim between 10- and 4-o'clock via multiple portals. This study evaluates
METHODS: In stage one, 11 patients (22 hips) underwent skin marking of surface portals followed by 0.625 mm CT acquisition; Mimics reconstructed the bony model, and Autodesk Maya simulated anchor trajectories to define a preliminary safety zone. In stage two, six formalin-fixed specimens (12 hips) were equipped with 3-D-printed, patient-specific guides after portal marking, dissected, and instrumented at 10-4 o'clock positions. Anchors inserted via anterior, anterolateral, and DALA portals validated the virtual safety map, after which the refined data were applied prospectively in clinical application.
RESULTS: Virtual anchoring revealed marked, position-dependent differences: the DALA portal at 12-o'clock achieved only 50.0% success, significantly below the anterolateral (86.4%) and anterior (90.9%) portals (
CONCLUSION: For arthroscopic labral repair, anchor placement should follow these portal-specific safe corridors: anterior portal-10, 11, 12, 1, 2, and 4 o'clock; anterolateral portal-10, 11, 12, and 2 o'clock; DALA portal-10, 11, 2, 3, and 4 o'clock.
中文总结
本研究旨在建立关节镜下盂唇修复术中缝合锚在髋臼边缘放置的安全区域。研究分两阶段进行：第一阶段通过皮肤标记和CT扫描重建三维骨骼模型，模拟锚道轨迹以界定初步安全区；第二阶段利用3D打印患者专用导板在尸体标本上进行验证，并将优化后的数据前瞻性应用于临床。研究结果表明，不同入路和不同钟点位对应的锚放置成功率存在显著差异：前入路在10、11、12、1、2及4点钟位置均具有较高成功率；前外侧入路在10、11、12及2点钟位置表现更优；而远端前外侧入路在10、11、2、3及4点钟位置更为安全。该研究为关节镜外科医生提供了基于循证医学的portal-specific安全走廊建议，有助于在保证锚放置疗效的同时最大程度避免髋臼穿透等并发症。
英文摘要 Abstract
Strategies to minimize damage to the iliofemoral ligament in hip arthroscopy for the treatment of femoroacetabular impingement syndrome have spawned increased curiosity among sports surgeons. Gone are the days when a large T-type capsulotomy or even capsulectomy is performed without some closure. Consensus to repair interportal capsulotomies seems strong. Under scrutiny now is whether the same rules apply to smaller periportal capsulotomies. If we continue to abide by our principles to respect anatomy and restore biomechanical properties, then capsular preservation should be upheld, especially in patients who need it the most.
中文总结
本篇编辑评论针对髋关节镜手术中关节囊处理策略进行了深入探讨。作者指出，为最大限度减少髋股韧带损伤而设计的各种技术已引起运动医学外科医生的高度关注。既往大规模T型关节囊切开术或关节囊切除术的时代已一去不复返，当前关于是否修复关节囊的共识已初步形成，尤其对于门间关节囊切开术的修复已达成了较强共识。然而，对于较小的经皮关节囊切开术是否应遵循相同原则仍存在争议。作者强调，若我们继续遵循尊重解剖结构及恢复生物力学特性的原则，则关节囊的保护与修复应当得到重视，尤其对于那些最需要完整关节囊功能的患者群体而言更具重要意义。
英文摘要 Abstract
PURPOSE: To evaluate the accuracy of navigation-assisted arthroscopic osteochondroplasty by focusing on the total volume and location of residual deformities, specifically by assessing the total amount and areas of residual deformities and determining whether residual cam deformities result in simulated residual impingement in postoperative computed tomography (CT)-based computer simulations.
METHODS: We analyzed pre- and postoperative CT data of patients with cam-type or combined-type femoroacetabular impingement who underwent navigation-assisted arthroscopic osteochondroplasty between November 2022 and May 2024. Preoperative planning included a virtual cam resection simulation to improve internal rotation by 10°. Three-dimensional models were created using Mimics and 3-matic software. Residual volume was calculated as a percentage of the planned resection volume, and residual thickness was quantified using a 3-mm threshold. Postoperative CT simulations at 0° adduction and 90° flexion were used to evaluate residual impingement.
RESULTS: Of 26 patients (27 hips) who underwent CT-based navigation-assisted arthroscopic osteochondroplasty, 4 hips were excluded due to congenital hip disorders, missing planning data, or magnification inconsistencies, leaving 23 hips in 22 patients for analysis. The residual volume was 1149.3 (634.6-1427.2) mm
CONCLUSIONS: Even with navigational assistance, insufficient cam resection and associated residual impingement may persist. The residual volume comprised 57.1% of the planned resection, with regions >3-mm thick accounting for 5.4%. The distal lateral region had substantial concordance with postoperative impingement areas.
LEVEL OF EVIDENCE: Level IV, retrospective therapeutic case series.
中文总结
本研究评估了在导航辅助下进行关节镜下骨软骨成形术的准确性，重点关注残留畸形的总体积和位置分布。研究纳入22例患者共23髋，术前基于虚拟cam切除模拟规划以改善内旋10度为目标。术后CT三维重建分析显示，残留体积占计划切除体积的57.1%，其中厚度超过3毫米的区域占5.4%。进一步分析表明，残留畸形集中于远端外侧区域，且该区域与术后CT模拟撞击测试中确认的残留撞击区域高度吻合。即使在导航系统的辅助下，cam畸形切除不充分的情况仍然存在，提示导航技术虽可提供重要参考，但手术操作的最终效果仍受多种因素影响，术者应认识到导航辅助并不能完全消除残余撞击风险，术后评估及必要的补充处理仍不可忽视。
英文摘要 Abstract
Acetabular retroversion (AR) has been found to be associated with the development of multiple symptomatic pathologies of the hip joint including femoroacetabular impingement syndrome, labral tears, chondral injuries, posterior instability, and the development of hip osteoarthritis. Many studies have showed good results with hip arthroscopy in patients with 2-dimensional imaging preoperatively utilized to diagnose AR. While plain radiographs can be helpful in preliminary evaluation for AR, its diagnosis can be more accurately made using 3-dimensional imaging. Surgeons should utilize 3-dimensional imaging quantitating femoral and acetabular version in addition to clinical exam when considering isolated HA for this potentially higher risk patient population.
中文总结
这篇编辑部评论深入探讨了髋臼扭转（Acetabular Retroversion, AR）与髋关节镜手术结果之间的关系及其影像学诊断的临床意义。研究指出，AR与多种髋关节病理性改变密切相关，包括股髋撞击综合征（FAIS）、盂唇损伤、软骨损伤、后壁不稳以及髋关节骨关节炎的发生发展。尽管既往研究显示基于二维影像学术前诊断AR的患者接受髋关节镜手术可获得良好疗效，但作者强调二维影像学在AR诊断中存在一定局限性。平面X线片虽可用于AR的初步筛查，但其诊断准确性不及三维影像学检查。因此，作者建议外科医生在评估存在AR高风险的患者时应充分利用三维影像学技术来定量评估股骨和髋臼的前倾角度，并结合详细的临床查体进行综合判断，从而制定更加精准的术前计划并改善患者的长期预后。这一观点对于髋关节外科医生在面对疑似AR患者时选择合适的影像学评估手段具有重要的指导意义。
英文摘要 Abstract
PURPOSE: To determine the angle of hip flexion at which femoral neck chondral lesions in patients with femoroacetabular impingement syndrome (FAIS) engage the labrum under direct arthroscopic visualization.
METHODS: Primary hip arthroscopy patients between 2022 and 2024 with intraoperatively identified femoral neck chondral lesions were included. Patients were flexed at the hip with the lower extremity in neutral rotation until the labrum engaged the femoral neck chondral lesion. Lateral photographs of the patient on the operating table were taken at this position, and degree of hip flexion was calculated using an online goniometer. Comparisons between the angle of impingement and patient demographics were assessed via two-tailed t-tests and one-way analysis of variance. Regression analysis was performed to evaluate the relationship between the impingement angle and various radiographic measurements while controlling for age, sex, and body mass index (BMI).
RESULTS: A total of 108 patients were analyzed in this study. Mean age was 31.0 ± 10.8 years, mean BMI was 26.4 ± 5.8 kg/m
CONCLUSIONS: Hip impingement in those with FAIS may routinely occur at hip flexion angles below 90° in neutral rotation, with males engaging at higher flexion angles than females. Furthermore, the angle of impingement directly correlates with femoral version and inversely correlates with alpha angles on radiographs.
LEVEL OF EVIDENCE: Level IV, case series.
中文总结
本研究旨在明确股骨颈软骨病变在股髋撞击综合征患者中与盂唇发生接触时的髋关节屈曲角度。研究纳入了2022年至2024年间接受初次髋关节镜手术且术中直接确认存在股骨颈软骨病变的患者。手术过程中，当髋关节处于中立位逐渐屈曲直至股骨颈软骨病变与盂唇接触时，拍摄患者侧位照片并使用在线量角器计算髋关节屈曲角度。研究人员采用回归分析评估撞击角度与多种影像学测量指标的相关性，同时控制年龄、性别和体重指数等混杂因素。最终共108例患者被纳入分析，平均年龄31.0±10.8岁。研究结果表明，股髋撞击综合征患者的髋关节撞击通常发生在髋关节屈曲角度低于90°时，且男性患者的撞击角度显著高于女性。回归分析显示，撞击角度与股骨前倾角呈直接正相关，而与X线片上测量的Alpha角呈负相关。这些发现提示临床医生在术前评估时应综合考虑患者的股骨前倾情况和Alpha角大小，以更好地预测髋关节撞击发生的位置和角度，从而指导手术策略的制定。
英文摘要 Abstract
PURPOSE: To evaluate the in vivo biomechanical effects of periportal capsulotomies, single (modified anterior portal [MAP]) portal repair, and complete (MAP + anterolateral portal [ALP]) repair on altering the resistance to axial distraction compared to the native state (i.e., precapsulotomy).
METHODS: Consecutive patients undergoing primary hip arthroscopy with periportal capsulotomies received intraoperative axial distraction testing at 0, 50, and 100 pounds of force (lbf). Patients were excluded if they did not break their suction seal with 100 lbf. Distraction testing was performed prior to capsulotomy (native), postcapsulotomy, after repair of just the MAP (partial repair), and after repair of both the MAP and ALP (complete repair). Distraction distances were calculated in millimeters (mm) as the difference in joint space between 0 and 50 or 100 lbf on intraoperative fluoroscopy from the lateral sourcil edge of the acetabulum to the femoral head. Repeated measures analysis of variance and Bonferroni-corrected P values were used for comparison.
RESULTS: Eighty-six patients were included (58% female; mean age, 33.6 ± 11.7 years). There was a significant increase in distraction distance in the unreparied capsulotomy state compared to the native state at 100 lbf (1.14 [0.33-1.96] mm, P = .03). After partial and complete repair, the distraction distance was significantly decreased compared to the native state at 100 pounds of traction by 1.09 mm (0.28-1.90, P < .001) and 2.84 mm (2.09-3.59, P < .001), respectively. In a subgroup analysis, males also had a substantial decrease in distraction distance with MAP closure alone compared to the native state at 100 lbf (1.33 [0.32-2.35] mm, P = .04), whereas females did not (0.92 [0.09-1.75] mm, P = .19).
CONCLUSIONS: The periportal capsulotomy causes a significant increase in hip distractibility compared to the native state, and both partial and complete capsular repair restore distraction resistance to levels at or greater than the native state.
LEVEL OF EVIDENCE: Level IV, retrospective case series.
中文总结
该研究旨在体内环境下评估不同囊膜修复策略对periportal囊膜切开术后髋关节轴向牵拉阻力的生物力学影响。研究纳入了连续接受初次髋关节镜手术并进行periportal囊膜切开的患者，术中在0、50和100磅力量条件下分别进行轴向牵拉测试。牵拉测试分别于囊膜切开前（天然状态）、囊膜切开后、单孔修复（仅修复MAP）后以及完全修复（MAP联合ALP修复）后进行。结果显示，86例患者被纳入分析，其中58%为女性，平均年龄33.6±11.7岁。与天然状态相比，未修复的囊膜切开后髋关节牵拉距离在100磅力量条件下显著增加，差异为1.14毫米。部分修复和完全修复均使牵拉阻力恢复至天然状态甚至更高水平，其中完全修复组在100磅牵拉下距离减少2.84毫米。亚组分析进一步显示，男性患者仅行MAP修复即可获得显著的牵拉阻力改善，而女性患者则需要完全修复才能达到类似效果。该研究证实了囊膜完整性对维持髋关节稳定性的重要作用，并提示完全囊膜修复可能更适合需要高关节稳定性的患者群体。
英文摘要 Abstract
Hip arthroscopy has proven to be beneficial for numerous patient populations. The currently limited literature regarding hip arthroscopy in patients with fibromyalgia shows promising early outcomes, suggesting that patients with fibromyalgia attain benefit from hip arthroscopy. Therefore, a diagnosis of fibromyalgia does not directly contraindicate hip arthroscopy. However, this does not negate the necessity for careful planning and expectation setting in patients with fibromyalgia. A multidisciplinary approach may provide substantial benefit to this population, as pain regiments require careful curation and the possibility of complex pharmacotherapy. Although findings in the short-term are positive, more studies confirming these findings and longer-term studies are required to attain a comprehensive understanding regarding optimizing outcomes of hip arthroscopy in the setting of fibromyalgia.
中文总结
这篇编辑部评论系统性地回顾了纤维肌痛症患者接受髋关节镜手术的临床现状、面临的挑战及未来发展方向。研究指出，尽管目前相关文献有限，但现有证据表明髋关节镜手术对纤维肌痛症患者可获得令人鼓舞的早期临床效果，提示纤维肌痛症本身并非髋关节镜手术的绝对禁忌证。然而，作者强调对该类患者进行仔细的术前评估和合理的预期管理仍然至关重要。建议采取多学科协作模式来优化此类患者的围手术期管理，因为纤维肌痛症患者的疼痛管理通常需要个体化的药物方案精心调整，包括可能的复杂药物治疗方案。尽管短期内研究结果积极乐观，但作者明确指出仍需更多高质量的长期随访研究来全面验证髋关节镜手术在纤维肌痛症患者中的安全性和有效性，并进一步探索如何在此特定患者群体中优化手术策略和术后康复方案，以获得最佳的长期临床效果。
英文摘要 Abstract
Navigational assistance for arthroscopic hip femoroacetabular impingement surgery does not equate to a more precise femoroplasty. Traction sutures, interportal capsulotomies, and curved burrs can improve access. A well done cam osteoplasty is only one part of a successful hip arthroscopy, and factors such as atraumatic access and labral and capsular management are important for optimal outcomes.
中文总结
这篇编辑部评论针对导航辅助技术在髋关节镜股髋撞击手术中的应用价值进行了深入而客观的探讨。作者指出，导航辅助技术并不等同于更精确的股骨成形术，尽管该技术可能为手术提供一定的帮助。编辑部观点认为，成功的髋关节镜手术涉及多个关键要素的协同作用，而非仅仅依赖导航技术。有效的手术入路建立需要综合运用牵引缝线、孔间囊膜切开术和弯头钻等器械和技术来改善操作视野。完善的Cam成形术虽然是成功手术的重要组成部分，但绝非唯一决定因素。此外，微创无创的入路建立、盂唇的妥善处理以及囊膜的合理管理对于实现最佳手术结果同样发挥着不可或缺的作用。因此，外科医生不应过度依赖导航技术，而应全面把握影响手术成功的多种因素，在术前规划和术中操作中综合考虑，以最大限度提高患者满意度并改善临床预后。这一观点对于临床医生理性看待和应用导航技术具有重要的启示意义。
英文摘要 Abstract
BACKGROUND: Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic condition. Caregivers of children with DDH often face significant challenges that may affect their quality of life. This review aimed to systematically identify, appraise, summarize the available qualitative evidence on caregivers' experiences of caring for children with DDH. METHODS: We systematically searched eight databases (Embase, Cochrane Library, Web of Science, PubMed, CINAHL, PsycINFO, ERIC, and ProQuest) from inception to May 2025. Two researchers independent screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A meta-aggregative approach was used to categorize and summarize themes reported in the primary studies. Confidence in each summary finding was assessed using GRADE-CERQual. RESULTS: Eight studies met the inclusion criteria. These included four interview-based studies (total 66 participants) and four survey-based studies with open-ended questions (total 1,522 participants). Four main themes were identified: (1) a challenging and often delayed diagnostic process; (2) treatment devices complicate daily parenting tasks; (3) inadequate or ill-timed informational and practical support; and (4) gradual adaptation and skill development over time. CONCLUSION: Caregivers of children with DDH face substantial challenges during diagnosis, treatment, and daily care. The findings highlight the potential value of timely, practical, and empathetic support that addresses informational needs and acknowledges the adaptive work families undertake. Future research should employ more in-depth qualitative designs to capture the nuanced processes of caregiver adaptation.
中文总结
本文为针对先前发表的关于'髋关节镜穿刺囊膜切开技术5年功能预后改善'一文的作者回复。该回复旨在回应读者就原研究提出的相关问题，对穿刺囊膜切开术的技术细节和临床效果进行了进一步阐述和说明。髋关节镜手术中囊膜的处理方式一直是髋关节外科领域的热点讨论话题，穿刺囊膜切开术作为一种微创技术手段，在有效保护髋关节囊功能完整性的前提下实现必要的手术操作，其安全性和有效性已在临床实践中得到初步验证。从该回复的标题可以判断，作者旨在澄清技术要点并进一步强调研究结论的可靠性。鉴于穿刺囊膜切开术在髋关节镜手术中的日益广泛应用，其长期临床预后值得持续关注和深入研究，以期为临床实践提供更加坚实的循证医学证据支持。
英文摘要 Abstract
BACKGROUND: Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic condition. Caregivers of children with DDH often face significant challenges that may affect their quality of life. This review aimed to systematically identify, appraise, summarize the available qualitative evidence on caregivers' experiences of caring for children with DDH. METHODS: We systematically searched eight databases (Embase, Cochrane Library, Web of Science, PubMed, CINAHL, PsycINFO, ERIC, and ProQuest) from inception to May 2025. Two researchers independent screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A meta-aggregative approach was used to categorize and summarize themes reported in the primary studies. Confidence in each summary finding was assessed using GRADE-CERQual. RESULTS: Eight studies met the inclusion criteria. These included four interview-based studies (total 66 participants) and four survey-based studies with open-ended questions (total 1,522 participants). Four main themes were identified: (1) a challenging and often delayed diagnostic process; (2) treatment devices complicate daily parenting tasks; (3) inadequate or ill-timed informational and practical support; and (4) gradual adaptation and skill development over time. CONCLUSION: Caregivers of children with DDH face substantial challenges during diagnosis, treatment, and daily care. The findings highlight the potential value of timely, practical, and empathetic support that addresses informational needs and acknowledges the adaptive work families undertake. Future research should employ more in-depth qualitative designs to capture the nuanced processes of caregiver adaptation.
中文总结
本篇为针对《关节镜杂志》发表的关于“穿刺关节囊切开术治疗髋关节镜术后5年患者功能结局改善”文章的致编辑信，两位作者就该研究中采用的技术方法及报告结果提出疑问并进行讨论，体现了学术界对髋关节镜技术优化与疗效评估的持续关注与审慎评估。
英文摘要 Abstract
PURPOSE: To compare adverse events, secondary surgery rates, opioid prescriptions, and medical resource utilization between patients undergoing hip arthroscopy with fibromyalgia and a propensity-matched control group without fibromyalgia.
METHODS: A retrospective review of the TriNetX national database identified patients who underwent hip arthroscopy between October 2015 and July 2023 with a preoperative fibromyalgia diagnosis. Propensity 1:1 matching was performed with controls who underwent hip arthroscopy without fibromyalgia. Postoperative adverse events, medical service utilization, opioid prescriptions, and secondary surgery rates were compared within 90 days, 1 year, and/or 2 years using Mann-Whitney U and χ
RESULTS: A total of 755 patients with fibromyalgia were matched to 755 controls. Mean age was similar (41.5 ± 10.7 vs 41.4 ± 11.6 years, P = .813), with comparable female representation (78.7% vs 78.4%, P = .900). No significant differences were found in revision arthroscopy (odds ratio [OR] 0.91, 95% confidence interval [CI]: 0.68-1.21, P = .502) or conversion to total hip arthroplasty (OR 1.07, 95% CI: 0.65-1.76, P = .798) within 2 years. Patients with fibromyalgia had higher odds of opioid prescription within 90 days (OR 1.56, 95% CI: 1.27-1.91, P < .001) and 1 year (OR 1.41, 95% CI: 1.15-1.74, P < .001) postoperatively. Rates of adverse medical events, mean prescriptions per patient (among those prescribed), secondary surgeries, and medical service utilization did not differ.
CONCLUSIONS: Contrary to the initial hypothesis, fibromyalgia was not associated with increased risk of postoperative adverse events, medical service utilization, revision surgery, or conversion to total hip arthroplasty after hip arthroscopy compared to the matched control. However, patients with fibromyalgia had significantly higher odds of receiving opioid prescriptions within both 90 days and 1 year postoperatively. Among those prescribed opioids, the mean number of prescriptions per patient did not differ significantly between cohorts.
LEVEL OF EVIDENCE: Level III, retrospective comparative case series.
中文总结
本研究利用TriNetX国家数据库进行回顾性分析，旨在比较纤维肌痛症患者与非纤维肌痛对照人群在髋关节镜手术后的不良事件、二次手术率、阿片类药物处方及医疗资源使用情况。通过倾向性评分1:1匹配，研究纳入了755例纤维肌痛症患者及755例对照。结果显示，两组在90天、1年及2年内的修订关节镜手术率（OR 0.91, P=0.502）及全髋关节置换转换率（OR 1.07, P=0.798）均无显著差异。然而，纤维肌痛症患者在术后90天（OR 1.56, P<0.001）及1年（OR 1.41, P<0.001）接受阿片类药物处方的几率显著增高。在接受阿片类药物处方的患者中，两组的平均处方量及医疗不良事件发生率无显著差异。该研究结果表明，纤维肌痛症本身并非髋关节镜手术的禁忌证，但临床医生应认识到该人群术后阿片类药物使用的增加，并采取多学科综合管理策略以优化疼痛控制和预后。
英文摘要 Abstract
PURPOSE: To characterize outcomes of femoroacetabular impingement syndrome patients with acetabular retroversion (AR) undergoing hip arthroscopy in studies reporting patient-reported outcomes (PROs), clinically significant outcomes, and reoperation rates.
METHODS: A search of PubMed, Scopus, and Embase was performed. The Methodological Index for Non-Randomized Studies assessed methodological quality, and Cohen's kappa coefficient measured inter-rater reliability. Included studies (1) presented original data, (2) were in English, (3) reported ≥2-year follow-up after primary hip arthroscopy for femoroacetabular impingement syndrome using PROs or reoperation rates, (4) assessed AR via computed tomography or X-ray, and (5) were Levels I-IV. Exclusions comprised nonclinical studies, secondary indications, congenital/traumatic/dysplastic hips, revision or worker's compensation cases, periacetabular osteotomy procedures, and pediatric patients. Due to heterogeneity, meta-analysis and data pooling were avoided.
RESULTS: Of 750 studies, 8 met inclusion criteria. Six were Level III cohort studies, and 2 were Level IV case series. The Methodological Index for Non-Randomized Studies scores ranged from 18 to 22 (comparative) and 9 to 13 (noncomparative). Across 3630 patients, 1157 had AR and 2473 had normal version (NV). All groups showed improvements in PROs postoperatively. Mean postoperative modified Harris Hip Score (mHHS) scores ranged from 68.2 to 87.1 (AR) and 80.6 to 86.9 (NV). Minimal clinically important difference achievement for mHHS ranged 61.5% - 89.5% (AR) and 69.5% - 92.1% (NV). Patient acceptable symptom state achievement for mHHS ranged 28.4% - 81.6% (AR) and 25.5% - 82.0% (NV). Revision rates ranged 2.6% - 10.2% (AR) and 0% - 10.7% (NV). Total hip arthroplasty conversion ranged 1.2% to 2.6% (AR) and 1.0% to 2.6% (NV). High total I
CONCLUSIONS: Hip arthroscopy for femoroacetabular impingement syndrome in patients with AR identified on plain radiography alone leads to significant improvements in PROs that are comparable to NV patients. Reoperation rates were similar between groups in the majority of studies.
LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies.
中文总结
该系统综述旨在评估髋关节镜治疗股髋撞击综合征患者中，髋臼反转畸形对临床结局的影响。研究团队检索了PubMed、Scopus和Embase数据库，采用非随机研究方法学指数进行质量评价，最终纳入8项符合标准的研究，涉及3630例患者，其中1157例存在髋臼反转畸形。结果显示，无论是否存在髋臼反转畸形，所有患者在术后患者报告结局量表评分均有显著改善。反转畸形组的改良Harris髋关节评分平均为68.2至87.1分，正常覆盖组为80.6至86.9分；最小临床重要差异达成率在两组间相近（61.5%-89.5%对比69.5%-92.1%），可接受症状状态达成率亦相似（28.4%-81.6%对比25.5%-82.0%）。两组在翻修手术率（2.6%-10.2%对比0%-10.7%）及全髋关节置换转换率（1.2%-2.6%对比1.0%-2.6%）方面亦无显著差异。该系统综述表明，基于现有文献，髋关节镜治疗股髋撞击综合征在合并髋臼反转畸形的患者中可获得与无畸形患者相当的临床结局。
英文摘要 Abstract
This study compared the effects of pericapsular nerve group (PENG) block and supra-inguinal fascia iliaca compartment block (FICB) on quadriceps strength, postoperative analgesia, and functional scores following hip arthroscopy (HA) for patient complaining of femoroacetabular impingement (FAI) under general anaesthesia. A prospective, randomized, and controlled trial recruited a total of 48 patients who had either PENG group or supra-inguinal FICB as a pain management modality. The primary outcomes were the postoperative quadriceps muscle power, and the secondary outcomes included pain scores, opioid consumption, and functional scores; the modified Harris hip score (mHHS) and international hip outcome tool-12 (iHOT-12) score. All patients in PENG group were capable of performing a straight leg raise with hip flexion of >15°. In contrast, two patients in FICB group had postoperative falls and six patients (25%) were unable to perform a straight leg raise at 24 h postoperatively. At the time of admission to the post-anaesthesia care unit and at 6, 12, and 24 h postoperatively, peak visual analogue scale (VAS) scores at rest were 6, 5, 4, and 4, respectively, in PENG group and 8, 7, 6, and 5, respectively, in FICB group (
中文总结
该前瞻性随机对照试验比较了两种区域阻滞技术——囊周神经组阻滞与髂筋膜室阻滞——在髋关节镜治疗股髋撞击综合征后对术后镇痛、股四头肌肌力及早期功能结局的影响。研究共纳入48例患者，随机分配至PENG组或FICB组。主要结局指标为术后股四头肌肌力，次要指标包括疼痛评分、阿片类药物消耗量及功能评分。PENG组所有患者均能完成直腿抬高动作且髋屈曲大于15度，而FICB组有2例患者术后发生跌倒，6例患者（25%）在术后24小时无法完成直腿抬高。在术后入住恢复室及术后6、12、24小时各时间点，PENG组的静息疼痛视觉模拟量表评分均显著低于FICB组（分别为6、5、4、4分对比8、7、6、5分）。该研究提示，对于接受髋关节镜手术的股髋撞击综合征患者，PENG阻滞在镇痛效果及保留股四头肌肌力方面均优于髂筋膜室阻滞。
英文摘要 Abstract
Periacetabular osteotomy (PAO) is performed to relieve symptomatic acetabular dysplasia by reorienting the acetabulum to provide adequate femoral head coverage. Due to an increased risk for complications in obese patients, some surgeons consider obesity as a contraindication for surgery. We theorize obese patients will have similar reductions in their pain levels and improvement in radiographic parameters despite an increased risk for postoperative complications. We performed a retrospective review of all patients who underwent a PAO in the last 12 years by the principal investigator. The incidence of complications, change in visual analogue scale (VAS) scores at 6 months follow up, and change in lateral centre edge angles (LCEAs) were then compared between obese patients and non-obese patient cohorts. Forty-eight hips in 41 patients were analysed. Fifteen hips were of obese patients at time of operation and 33 hips were of non-obese patients. The number of complications in the obesity group was statistically significant with a
中文总结
本回顾性研究探讨了肥胖是否应作为髋臼周围截骨术的禁忌证。研究纳入了41例患者共48髋，其中肥胖患者15髋，非肥胖患者33髋，旨在比较两组患者在术后6个月随访时的并发症发生率、疼痛缓解程度及影像学参数改善情况。髋臼周围截骨术通过重新定位髋臼以增加股骨头覆盖率，从而缓解症状性髋臼发育不良带来的疼痛。尽管肥胖患者组的并发症发生率在统计学上显著高于非肥胖组，但研究结果表明，肥胖患者在疼痛水平降低及外侧中心边缘角等影像学参数改善方面与正常体重患者相当。基于上述发现，研究者认为肥胖不应被视为髋臼周围截骨术的绝对禁忌证，外科医生在为肥胖患者制定手术决策时应权衡并发症风险与功能改善的潜在获益。
英文摘要 Abstract
This case series aims to share our experience with arthroscopic circumferential allograft labral reconstruction (CLR) as a part of the treatment for femoroacetabular impingement (FAI) syndrome in 34 nonarthritic hips of patients aged 60 and older. Twenty-nine patients had a minimum follow-up of 36 months (ranging from 3 to 10 years), with one case converting to total hip arthroplasty. Five patients were lost to follow-up. Significant improvements were observed across all patient-reported outcomes used at the last follow-up. Modified Harris Hip Scores improved by a mean of 40 points (
中文总结
本研究报道了60岁及以上老年患者接受关节镜下环形同种异体移植物盂唇重建术治疗股髋撞击综合征的临床经验。该病例系列纳入了34例非关节炎髋关节患者，其中29例完成至少36个月随访（范围3至10年），1例在随访期间转换为全髋关节置换术，5例失访。结果显示，所有患者在末次随访时的患者报告结局评分均较术前显著改善，改良Harris髋关节评分平均提高40分。该研究表明，年龄本身并非关节镜盂唇重建术的制约因素，老年患者接受该手术后可获得显著的功能改善和生活质量提升，为老年股髋撞击综合征患者的保髋治疗提供了新的循证依据。
英文摘要 Abstract
Focal femoral head degeneration can lead to loss of structural support of the femoral head and eventual collapse. Formerly, total hip arthroplasty (THA) was the only definitive means available to restore function and mitigate pain. Osteochondral allograft transplantation (OATS) of the femoral head can be used to potentially prevent or delay THA, and the aim of this study is to analyse outcomes of patients who have undergone OATS procedures. An OATS procedure involves vessel-sparing hip dislocation to achieve global femoral head exposure, removal of damaged cartilage and subchondral bone, and press-fit implantation of a fresh femoral head allograft. Eleven patients have undergone OATS at our institution, and we collected retrospective data and Patient-Reported Outcome Measurement Information System (PROMIS) data. All eleven patients demonstrated focal femoral head degeneration. Six patients underwent simultaneous PAO for concomitant structural instability. Postoperatively, patients returned to weight bearing by an average of 9.8 ± 5.6 weeks and physical activities in 9.9 ± 2.9 months. Four patients had unrelated health conditions limiting physical activity involvement. One patient had undergone THA, 6 years postoperatively. Five patients provided updated follow-up metrics, demonstrating significant improvement in average physical function PROMIS scores (
中文总结
本研究报道了股骨头骨软骨同种异体移植移植术治疗局灶性股骨头退变的临床结局，并探讨了同时行髋臼周围截骨术对预后的影响。股骨头局灶性退变可导致结构支撑丧失及股骨头塌陷，传统上全髋关节置换是唯一的确定性治疗手段。骨软骨同种异体移植术通过血管保留髋关节脱位入路暴露股骨头，清除损伤软骨及软骨下骨，并以压配方式植入新鲜股骨头同种异体移植物。本研究纳入11例患者，其中6例因合并结构性不稳而同时行髋臼周围截骨术。术后患者平均在9.8周后恢复负重，9.9个月恢复体育活动。1例患者在术后6年接受了全髋关节置换术。5例患者提供了更新随访数据，显示体质功能患者报告结局测量信息系统评分较术前显著改善。该技术为推迟或避免年轻患者全髋关节置换术提供了可行的保髋方案。
英文摘要 Abstract
The alpha angle is commonly used to quantify cam-type morphologies in hips. However, the threshold values that define a pathological alpha angle remains disputed. To identify the threshold values for the alpha angle measured on X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) in asymptomatic individuals in different radiological modalities. Using the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines and checklist, a literature search was conducted in May 2024 by two independent reviewers. The PubMed, Embase, Cochrane, and CINAHL databases were searched using the following search terms: ('Alpha angle') AND (('FAI') OR 'femoroacetabular impingement') AND ((((Imaging) OR CT) OR MRI) OR X ray). Of the studies identified, those measuring the alpha angle using either X-ray, CT, or MRI in an asymptomatic population were included. Study population and, if stated, demographics like gender, ethnicity, and activity level were then compiled using Excel as well as number of individuals and hips, imaging modality and view, method of evaluating symptoms, mean alpha angle, and 95% reference interval. Twenty-five articles were included in the review. Threshold values varied depending on what radiological method was used, with thresholds for X-ray ranging from 61.0° to 122.9°, thresholds for CT ranging from 50.0° to 95.3°, and thresholds for MRI ranging from 52.7° to 103.5°. According to current literature, threshold values indicating increased risk of FAI syndrome vary physiologically and depend on imaging view and modality. Therefore, no single cut-off reliably defines cam morphology and measurements should be interpreted within their clinical context.
中文总结
本研究系统综述了无症状人群髋关节α角测量值的报告差异，旨在确定用于界定病理性α角的阈值。α角是量化cam型畸形的常用影像学指标，但关于其正常与异常临界值尚存争议。研究人员依据PRISMA指南检索了PubMed、Embase、Cochrane和CINAHL数据库，最终纳入25项研究。分析表明，不同影像学方法测得的阈值存在显著差异：X线测量范围为61.0°至122.9°，CT为50.0°至95.3°，MRI为52.7°至103.5°。这些数据表明，当前文献中用于提示股髋臼撞击综合征风险的阈值受影像学检查方法和投照体位的影响甚大，不存在能够可靠界定cam畸形的单一临界值。因此，α角测量结果应结合具体临床情况进行解读，不应孤立地依据某一项阈值做出诊断决策。本综述强调了影像学参数标准化报告的必要性，以及在评估髋关节形态时综合考虑多种因素的临床重要性。
英文摘要 Abstract
PURPOSE: To evaluate the results of arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) with concomitant labrum ossification (LO) using patient-reported outcome measures (PROMs). The hypothesis was that at 2-year follow-up, an improvement in PROMs would be observed.
METHODS: A group of 24 patients (28 hips) with FAIS and LO findings were eligible for inclusion. In total 14 patients (18 hips) were included in the final PROMs analysis. The International Hip Outcome Tool short version (iHOT-12) was the primary outcome. The Copenhagen Hip and Groin Outcome Score (HAGOS), the European Quality of Life-5 Dimensions Questionnaire (EQ-5D), the EQ-visual analogue scale (EQ VAS), the Hip Sports Activity Scale for physical activity level, the VAS for overall hip function and a single question regarding overall satisfaction with the surgery were the secondary outcomes.
RESULTS: At 2-year follow-up 6 out of 24 (25%) patients had undergone total hip arthroplasty (THA). Comparing PROMs preoperatively with 2-years follow-up for the group of patients that did not undergo THA (
CONCLUSION: Patients with FAIS and LO who had not undergone THA at 2-year follow-up following arthroscopic treatment showed improved outcomes regarding patient-reported outcomes. Level of evidence: Case series, level IV.
中文总结
本研究探讨了盂唇骨化（LO）患者接受关节镜手术治疗股髋臼撞击综合征（FAIS）的临床结局。盂唇骨化作为一种特殊的病理改变，其对手术疗效的影响尚未明确。研究纳入24例（28髋）合并盂唇骨化的FAIS患者，其中14例（18髋）完成至少2年随访并纳入预后分析。主要结局指标为国际髋关节预后工具12项版（iHOT-12），次要指标包括哥本哈根髋腹股沟结局评分、生活质量评分及疼痛视觉模拟量表等。随访结果显示，24例患者中有6例（25%）在2年时已接受全髋关节置换术。在未行关节置换的患者中，患者报告的结局指标较术前显著改善，提示关节镜手术对合并盂唇骨化的FAIS患者仍可获得良好的临床疗效。本研究为该相对少见病理类型的治疗提供了有价值的临床参考，表明盂唇骨化并非关节镜手术的禁忌证，但需充分告知患者存在较高的关节置换风险。
英文摘要 Abstract
BACKGROUND: Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic condition. Caregivers of children with DDH often face significant challenges that may affect their quality of life. This review aimed to systematically identify, appraise, summarize the available qualitative evidence on caregivers' experiences of caring for children with DDH. METHODS: We systematically searched eight databases (Embase, Cochrane Library, Web of Science, PubMed, CINAHL, PsycINFO, ERIC, and ProQuest) from inception to May 2025. Two researchers independent screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A meta-aggregative approach was used to categorize and summarize themes reported in the primary studies. Confidence in each summary finding was assessed using GRADE-CERQual. RESULTS: Eight studies met the inclusion criteria. These included four interview-based studies (total 66 participants) and four survey-based studies with open-ended questions (total 1,522 participants). Four main themes were identified: (1) a challenging and often delayed diagnostic process; (2) treatment devices complicate daily parenting tasks; (3) inadequate or ill-timed informational and practical support; and (4) gradual adaptation and skill development over time. CONCLUSION: Caregivers of children with DDH face substantial challenges during diagnosis, treatment, and daily care. The findings highlight the potential value of timely, practical, and empathetic support that addresses informational needs and acknowledges the adaptive work families undertake. Future research should employ more in-depth qualitative designs to capture the nuanced processes of caregiver adaptation.
中文总结
本篇为针对先前发表的"实验性诱导股髋臼撞击症导致髋关节骨关节炎"一文的正式勘误通知。股髋臼撞击症是股骨头与髋臼边缘异常接触所致的病理状态，好发于年轻活跃人群，可引发髋关节疼痛、软骨损伤及早期骨关节炎。勘误内容涉及对原文中数据、方法或作者信息的更正，以维护科学文献的准确性与学术完整性。
英文摘要 Abstract
BACKGROUND: Long-term outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) have been promising, but no studies to date have examined the effect of body mass index (BMI) on 10-year outcome scores and reoperation rates.
PURPOSE: To compare outcome scores and reoperation rates between normal-weight, overweight, and obese patients undergoing hip arthroscopy for FAIS at 10-year follow-up.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: Preoperative, 2-year, 5-year, and 10-year scores for patient-reported outcome measures (PROMs) in patients undergoing surgery between January 2012 and June 2014 were collected. These included the Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), 12-item International Hip Outcome Tool (iHOT-12), visual analog scale (VAS) for pain, and VAS for satisfaction. Clinically significant outcomes were also collected including the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS). Patients were stratified into the normal-weight (18.5-24.9 kg/m
RESULTS: A total of 168 patients, with a mean follow-up time of 10.3 ± 0.4 years, who underwent hip arthroscopy for FAIS were included in the study: 56 normal weight, 56 overweight, and 56 obese. While all groups had similar significant improvements in PROM scores by 10-year follow-up (all
CONCLUSION: There were significant improvements in all outcome scores across all BMI groups by 10 years after the arthroscopic treatment of FAIS. Obese patients tended to have worse PROM scores at most follow-up time points but similar magnitudes of improvement from preoperatively. Obese and overweight patients converted to THA at significantly higher rates compared with normal-weight patients.
中文总结
本研究探讨了体质指数（BMI）对股髋臼撞击综合征患者髋关节镜术后10年临床结局和再手术率的影响。研究纳入了168例于2012年1月至2014年6月间接受髋关节镜手术的患者，依据BMI分为正常体重组、超重组和肥胖组，每组各56例，平均随访时间为10.3±0.4年。评估指标包括髋关节结局评分日常生活分量表、运动分量表、改良Harris评分、iHOT-12评分、疼痛视觉模拟量表及满意度评分等患者报告结局，同时记录最小临床重要差异和可接受症状状态的达标率。结果显示，所有BMI组别患者在10年随访时各项评分均较术前显著改善，表明髋关节镜手术的长期疗效稳定。虽然肥胖患者在多数随访时点的评分略低于正常体重组，但各组间改善幅度相近，提示BMI并不影响手术的相对获益。然而，肥胖和超重患者的全髋关节置换转换率显著高于正常体重患者，表明BMI是影响关节存活时间的独立危险因素。上述发现提示，对于不同BMI患者群体，髋关节镜手术均可获得功能改善，但需重视对肥胖患者进行更高强度的术后监测和风险管理。
英文摘要 Abstract
BACKGROUND: Some studies have reported more severe chondral pathology and less successful hip arthroscopic outcomes in patients with acetabular subchondral cysts.
PURPOSE/HYPOTHESIS: The purpose of this study was to report multicenter arthroscopic outcomes of patients with and without acetabular bone cysts. It was hypothesized that patients with acetabular cysts would demonstrate inferior outcomes at minimum 2-year follow-up compared with patients without acetabular cysts.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: A multicenter matched-pair study was performed across 6 medical centers with data from a large prospectively collected database. Inclusion criteria were adult patients who had undergone primary unilateral hip arthroscopy for femoroacetabular impingement syndrome (FAIS). The study group was defined by the presence of a superolateral acetabular subchondral cyst on preoperative imaging. A control group was matched on age; sex; body mass index (BMI); lateral center-edge angle (LCEA); alpha angle; arthroscopic treatments of femoroplasty, acetabuloplasty, and labral treatment (ie, repair, reconstruction, or debridement); Beck chondral grade; and minimum 2-year outcomes using visual analog scale (VAS) for pain, International Hip Outcome Tool-12 (iHOT-12), minimal clinically important difference (MCID), substantial clinical benefit (SCB), and Patient Acceptable Symptom State (PASS).
RESULTS: The study included 82 patients, of whom 41 composed the study group and 41 served as matched control patients. The study group had a mean age of 42.16 ± 11.26 years with 48.78% women and a mean BMI of 26.51 ± 4.31 kg/m
CONCLUSION: Patients undergoing arthroscopic surgery for FAIS with acetabular cysts had similarly successful outcomes as patients without acetabular cysts. Acetabular subchondral cysts may not be a contraindication to hip arthroscopy in patients with FAIS who would otherwise be indicated for this surgery.
中文总结
本研究由MASH研究组开展，是一项多中心配对对照研究，旨在评估髋关节镜治疗股髋臼撞击综合征（FAIS）合并髋臼囊肿患者的临床结局，既往研究提示该类患者软骨病理改变更为严重，疗效可能欠佳。研究在6个医学中心共纳入82例患者，其中41例术前影像学证实存在髋臼上外侧软骨下囊肿，41例无囊肿患者作为配对对照，两组在年龄、性别、BMI、外侧中心边缘角、α角、软骨损伤分级及手术方式等方面均匹配良好。评估指标包括疼痛视觉模拟量表、iHOT-12评分、最小临床重要差异（MCID）、实质性临床获益（SCB）及可接受症状状态（PASS）等。结果显示，合并髋臼囊肿组与对照组的各项结局指标无显著差异，两组患者均获得了满意的手术疗效。研究结论认为，髋臼软骨下囊肿不应被视为髋关节镜治疗FAIS的禁忌证，对于符合手术指征的合并囊肿患者，关节镜手术仍可取得与无囊肿患者相当的良好预后。
英文摘要 Abstract
BACKGROUND: Master athletes (MAs), or athletes older than age 40 years, make up a patient population whose midterm outcomes after primary hip arthroscopy are largely unstudied.
PURPOSE: To report minimum 5-year outcomes of MAs after primary hip arthroscopy and compare their results to a matched nonathlete (NA) control group.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: Data were collected between February 2008 and April 2019 and reviewed for all patients who underwent primary hip arthroscopy. Patients were excluded if they were younger than age 40 years and had previous ipsilateral hip pathology, dysplasia (lateral center-edge angle <18°), Tönnis grade >1, or workers' compensation claims. Patients included in the MA cohort reported participation in sports within 1 year before surgery and had a 5-year minimum follow-up. MAs were matched to NAs in a 1:1 ratio based on age, sex, body mass index, and acetabular Outerbridge grade. Patient characteristics, radiographic measurements, intraoperative findings, surgical procedures performed, and patient-reported outcomes (PROs) were compared between the groups. Additionally, rates of meeting clinically relevant thresholds and secondary procedures were compared.
RESULTS: A total of 118 hips were included in the study, with 59 hips per group. The groups showed comparable demographics, intraoperative findings, and labral procedures. The MA group had higher preoperative and postoperative values for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score, and Hip Outcome Score Sport-Specific Subscale (HOS-SSS) (
CONCLUSION: When compared with a propensity-matched control group of NA patients, MAs had better preoperative and postoperative PRO scores. However, the magnitudes of improvement in PROs were comparable between the groups. Furthermore, MAs met clinically meaningful thresholds at higher rates and had higher arthroplasty-free survivorship when compared with the NA group.
中文总结
本研究旨在探讨40岁以上运动员患者接受初次髋关节镜手术后的中期临床预后，并将其与匹配的非运动员对照组进行比较。研究纳入了2008年2月至2019年4月期间接受初次髋关节镜手术的患者，按照年龄、性别、体重指数及髋臼软骨Outerbridge分级进行1:1倾向性匹配，最终每组纳入59髋，共118髋。结果显示，运动员组在术前及术后的改良Harris髋关节评分、非关节炎髋关节评分及髋关节结局评分运动专项分量表上均高于非运动员组，但两组的改善幅度相近。运动员组达到临床重要差异阈值及患者可接受症状状态的比率更高，且免于关节置换的存活率也显著优于对照组。该研究表明，尽管运动员患者在功能评分起点和终点上均表现更优，但髋关节镜手术对两类人群带来的相对改善程度相当，而运动员群体在长期随访中展现出更好的关节保留结局，这可能与其较高的基线功能水平及术后康复依从性有关。
英文摘要 Abstract
BACKGROUND: Femoroacetabular impingement (FAI) is a common cause of hip pain, often treated with arthroscopy. The optimal approach among unilateral, staged bilateral, and simultaneous bilateral procedures remains unclear due to limited comparative data.
PURPOSE: To compare clinical outcomes and complication rates among simultaneous bilateral, staged bilateral, and unilateral hip arthroscopy in patients with FAI syndrome.
STUDY DESIGN: Systematic review and Meta-analysis; Level of evidence, 3.
METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Scopus, and Ovid MEDLINE databases were searched through April 2025. Eligible comparative studies included patients with FAI undergoing hip arthroscopy via unilateral, simultaneous bilateral, or staged bilateral approaches and reported outcomes such as patient-reported scores, complications, and revision or conversion to total hip arthroplasty (THA).
RESULTS: Nine studies with a total of 4040 hips were included. All surgical approaches showed significant improvements in pain and functional outcome scores. There were no statistically significant differences in postoperative visual analog scale score, Modified Harris Hip Score, Non-Arthritic Hip Score, International Hip Outcome Tool-12 score, rates of revision surgery, or conversion to THA among the 3 groups. Meta-analyses confirmed similar outcomes between staged and unilateral groups. Although 1 study reported a lower THA conversion rate in the simultaneous group, findings were inconsistent across the literature.
CONCLUSION: Simultaneous bilateral, staged bilateral, and unilateral hip arthroscopy offer comparable short- to midterm outcomes and complication rates in FAI patients. Simultaneous bilateral arthroscopy may represent a safe and efficient option for appropriately selected patients. Surgical approaches should be individualized based on patient symptoms, goals, and risk profile.
REGISTRATION: PROSPERO (CRD420251039957).
中文总结
该系统综述与荟萃分析旨在比较单侧、分期双侧及同期双侧髋关节镜手术治疗股髋臼撞击综合征的临床疗效及并发症发生率。研究遵循PRISMA指南，检索了PubMed、Scopus及Ovid MEDLINE数据库中截至2025年4月的相关文献，最终纳入9项研究共4040髋。分析表明，三种手术方式在疼痛视觉模拟评分、改良Harris髋关节评分、非关节炎髋关节评分、国际髋关节结局工具-12评分、翻修手术率及全髋关节置换转换率等方面均无统计学显著差异。分期双侧与单侧手术的比较结果一致，而同期双侧手术在部分研究中显示出较低的关节置换转换率，但结果在不同文献间存在不一致性。综合现有证据，三种入路方式在股髋臼撞击综合征患者中均可提供相似的短期至中期疗效，且同期双侧髋关节镜手术对于经筛选的合适患者可能是一种安全且高效的治疗选择，但应综合考虑患者症状特点、功能目标及个体风险因素进行个性化决策。
英文摘要 Abstract
BACKGROUND: Previous studies have shown good mid-term outcomes of hip labral tear treatment with arthroscopy. However, long-term results are limited within the young adult population.
PURPOSE: To report survivorship and patient-reported outcome measures (PROMs) at a minimum 10-year follow-up in young adult patients after primary hip arthroscopy with labral repair or debridement.
STUDY DESIGN: Case Series; Level of evidence, 4.
METHODS: Data were prospectively collected and retrospectively reviewed on all patients who underwent primary hip arthroscopy between June 2008 and August 2012. Young adult patients, aged >19 and <40 years, who underwent labral debridement repair or reconstruction and concomitant procedures were included. Preoperative and minimum 10-year follow-up data for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), iHOT-12 (International Hip Outcome Tool), and visual analog scale for pain (VAS-Pain) were collected. The exclusion criteria were previous ipsilateral hip surgery/conditions, Tönnis grade >1, hip dysplasia, workers' compensation status, or femoral head and acetabular Outerbridge scores of 4. Rates of achieving the minimal clinically important difference (MCID) and the patient acceptable symptomatic state (PASS), as well as hip joint survival from conversion to total hip arthroplasty and progression to subsequent ipsilateral revision hip arthroscopy, were reported.
RESULTS: Of the 241 hips eligible for analysis, 194 hips (80.5%) had a minimum 10-year follow-up. A total of 122 women (62.9%) and 72 men (37.1%) were included in the present analysis, with a mean age of 28.9 years and a mean body mass index of 24.8 kg/m
CONCLUSION: Young adults who underwent primary hip arthroscopy with labral treatment demonstrated an overall 10-year survivorship of 91.8%, significant improvements in PROMs, and high achievement rates of PASS for the mHHS and MCID for the mHHS, NAHS, and VAS-Pain.
中文总结
本研究报道了年轻成年患者接受髋关节镜下唇撕裂治疗后至少10年的假体存活率及患者报告结局指标。研究纳入了2008年6月至2012年8月期间接受初次髋关节镜手术且年龄在19至40岁之间的患者，排除既往同侧髋部手术史、Tönnis grade超过1级、髋关节发育不良、工会赔偿状态及股骨头或髋臼Outerbridge 4级软骨损伤者，最终241髋中有194髋（80.5%）完成至少10年随访。结果显示，年轻成年患者接受初次髋关节镜下唇修复或清理术后10年总体假体存活率达91.8%，所有评估的患者报告结局指标均较术前显著改善。在达到患者可接受症状状态方面，改良Harris髋关节评分的达标率较高，而改良Harris髋关节评分、非关节炎髋关节评分及疼痛视觉模拟评分的最小临床重要差异达标率同样令人满意。该研究表明，髋关节镜手术作为年轻成人髋唇损伤的治疗手段可提供持久的疼痛缓解和功能改善，具有良好的长期假体存活率。
英文摘要 Abstract
BACKGROUND: Hip arthroscopy has demonstrated favorable short- and mid-term outcomes for femoroacetabular impingement syndrome (FAIS) in patients with borderline hip dysplasia (BHD). However, long-term outcomes in patients with FAIS and BHD treated with hip arthroscopy remain understudied.
PURPOSE: To evaluate hip survivorship and patient-reported outcomes (PROs) in patients with FAIS and BHD compared with those without BHD at a minimum 10-year follow-up.
STUDY DESIGN: Cohort Study; Level of evidence, 4.
METHODS: A retrospective matched-cohort study was conducted on patients undergoing primary hip arthroscopy for FAIS by a single surgeon (2012-2024). BHD was defined as a lateral center-edge angle (LCEA) of 20° to 25°. Patients with BHD were matched 1 to 2 to controls without BHD based on age, sex, body mass index, and preoperative modified Harris Hip Score (mHHS). Radiographic parameters (eg, alpha angle, LCEA) were assessed pre- and postoperatively. PROs-including mHHS, Non-Arthritic Hip Score (NAHS), and hip survivorship (revision arthroscopy, conversion to total hip arthroplasty [THA])-were compared.
RESULTS: The study included 23 patients with BHD (mean age, 33.6 years; 69.6% women) and 46 controls (mean age, 32.7 years; 65.2% women). Both groups showed significant improvements in mHHS and NAHS at 10 years (all
CONCLUSION: At a minimum 10-year follow-up, patients with BHD who underwent hip arthroscopy for FAIS achieved comparable PROs and hip survivorship to those without BHD. These findings support the use of hip arthroscopy as a durable and effective treatment for FAIS in this population.
中文总结
本研究旨在评估合并边界型髋关节发育不良的股髋臼撞击综合征患者接受髋关节镜手术后至少10年的髋关节存活率及患者报告结局，并与无发育不良的匹配对照进行比较。边界型髋关节发育不良定义为外侧中心-边缘角在20°至25°之间。研究纳入了2012年至2024年间由同一术者完成的初次髋关节镜手术患者，按照年龄、性别、体重指数及术前改良Harris髋关节评分进行倾向性匹配，最终边界型发育不良组纳入23例患者，对照组纳入46例。结果表明，两组患者在10年随访时改良Harris髋关节评分及非关节炎髋关节评分均较术前显著改善，且组间差异无统计学显著性。髋关节存活率（以翻修手术或全髋关节置换转换为终点）在两组间也无显著差异。该研究结果支持髋关节镜手术作为合并边界型髋关节发育不良的股髋臼撞击综合征患者的有效且持久治疗手段，可实现与无发育不良患者相当的功能预后和假体存活率。
英文摘要 Abstract
BACKGROUND: Painful external snapping hip (ESH) is estimated to affect 5% to 10% of the population. Hip arthroscopy treating ESH concomitantly with femoroacetabular impingement (FAI) has shown favorable short-term outcomes.
PURPOSE: To report midterm outcomes of hip arthroscopy that concomitantly treats FAI and ESH, with a secondary comparison of these results to benchmark a control group of hips with FAI without ESH.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: Data were retrospectively analyzed for patients who underwent hip arthroscopy as treatment for FAI and iliotibial band (ITB) and gluteus maximus tendon release as treatment for painful ESH between 2008 and 2019. Patients were included if they had complete pre- and postoperative patient-reported outcomes (PROs) and visual analog scale (VAS) for pain scores with a minimum follow-up of 5 years or if they had a documented endpoint (revision surgery or conversion to arthroplasty) during the study period. Rates of revision surgery and conversion to total hip arthroplasty were included in the analysis. Patients were propensity matched to a benchmark control group of patients with FAI without ESH at a 1:4 ratio by sex, age at surgery, body mass index, acetabular Outerbridge grade, labral treatment, and capsular treatment.
RESULTS: A total of 215 hips (211 patients) were included in the study. The ESH study group showed significant improvements in all assessed PROs, with 98% of patients reporting resolution of painful external snapping at the latest follow-up, and no patient requiring revision hip arthroscopy secondary to a persistent external snapping. When compared with the benchmark control group, patients with ESH had similar preoperative outcomes for the modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score Sports-Specific Subscale, 12-item International Hip Outcome Tool score, and VAS score with equivalent magnitudes of improvement. Additionally, similar postoperative scores across all PROs and patient satisfaction were met. The minimal clinically important difference and Patient Acceptable Symptom State for all evaluated PROs were met at similar rates. Similar rates of complication revision hip arthroscopy and conversion to hip arthroplasty were observed between the groups.
CONCLUSION: Primary hip arthroscopy addressing FAI and painful ESH with ITB and gluteus maximus tendon release demonstrated significant improvement in all evaluated PROs, with 98% of patients reporting resolution of external snapping, and no revision surgery due to external snapping recurrence at the minimum 5-year follow-up. Functional outcomes and rates of clinically relevant threshold achievement were comparable to those of a propensity-matched benchmark control group with FAI without ESH.
中文总结
本研究报道了关节镜同时治疗股髋臼撞击综合征合并疼痛性外部髋关节弹响的中期临床预后，并将其与仅患有股髋臼撞击综合征的倾向性匹配对照组进行比较。研究回顾性分析了2008年至2019年间接受髋关节镜手术的患者群体，术中同时进行髂胫束松解及臀大肌腱松解以治疗疼痛性外部弹响髋关节，按照性别、年龄、体重指数、髋臼Outerbridge分级、唇部处理方式及关节囊处理方式进行1:4倾向性匹配。最终研究纳入215髋（211例患者），最短随访时间为5年。结果显示，研究组在所有评估的患者报告结局指标上均较术前显著改善，98%的患者在末次随访时报告外部髋关节弹响已消失，且无患者因持续性外部弹响而需要翻修手术。与对照组相比，研究组在术前基线评分、术后评分及改善幅度上均无统计学显著差异，达到最小临床重要差异及患者可接受症状状态的比率也相当。该研究表明，髋关节镜下同时处理股髋臼撞击综合征与疼痛性外部髋关节弹响可获得满意的中期疗效，功能结局与单纯股髋臼撞击综合征患者相当。
英文摘要 Abstract
BACKGROUND: Anterolateral acetabular overcoverage, also known as acetabular retroversion, can cause femoroacetabular impingement syndrome (FAIS). Various surgical options have been suggested for treatment, ranging from anteverting periacetabular osteotomy to isolated hip arthroscopy.
PURPOSE/HYPOTHESIS: The purpose of this study was, primarily, to analyze minimum 10-year outcomes of arthroscopic management of labral pathology in the setting of acetabular retroversion without dysplasia and, secondarily, to compare their outcomes to a propensity-matched group of nonretroverted patients. It was hypothesized that the outcomes of arthroscopic management would be comparable to those of the propensity-matched nonretroverted group and comparable to previously published outcomes of open treatment of acetabular retroversion.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: Prospectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy for FAIS and labral tear treatment between June 2008 and December 2013 and had a minimum of 10-year follow-up data. Retroversion was determined based on the presence of an ischial spine sign, >20% crossover sign, and posterior wall sign. Propensity score matching was used to identify a control group without retroversion who were matched 1:1 with similar age, sex, body mass index, acetabular and femoral head Outerbridge grade, preoperative lateral center-edge angle, and labral treatment.
RESULTS: A total of 95 hips with acetabular retroversion were matched to a control group. The groups were equally matched in demographic variables. Significant improvements were seen in all patient-reported outcomes (PROs) collected in both groups, with a similar survivorship of 96% in both groups; 4 patients in each group converted to a total hip replacement. The acetabular retroversion cohort achieved similarly high rates of minimal clinically important difference and Patient Acceptable Symptom State and higher rates of substantial clinical benefit for modified Harris Hip Score compared with the control group (
CONCLUSION: Patients with acetabular retroversion who had FAIS and labral tears could be safely treated using advanced hip arthroscopic techniques without reverse (anteverting) periacetabular osteotomy in a high-volume surgeon's hands. Patients with acetabular retroversion demonstrated favorable PROs and low rates of revision arthroscopy and conversion to total hip arthroplasty at long-term follow-up, which was comparable with a propensity-matched control group without acetabular retroversion.
中文总结
本研究旨在探讨不伴发育不良的髋臼后倾患者接受先进关节镜技术治疗后至少10年的长期预后，并将其与倾向性匹配的无后倾对照进行比较。髋臼后倾即前外侧髋臼过度覆盖，可导致股髋臼撞击综合征。研究纳入了2008年6月至2013年12月期间接受髋关节镜手术且有至少10年随访数据的患者，后倾的诊断依据为坐骨棘征、超过20%的交叉征及后壁征。倾向性评分匹配用于建立在年龄、性别、体重指数、髋臼及股骨头Outerbridge分级、术前外侧中心-边缘角及唇部处理方式上1:1匹配的对照组。结果显示，95髋的后倾患者与匹配对照在所有患者报告结局指标上均较术前显著改善，两组假体存活率均为96%，各有4例患者转换为全髋关节置换。后倾组在改良Harris髋关节评分的实质性临床获益达标率上甚至高于对照组。该研究表明，由高手术量术者在经验丰富的条件下，可安全地采用先进关节镜技术治疗合并髋臼后倾的股髋臼撞击综合征，无需进行反向髋臼截骨术，且长期预后与无髋臼后倾患者相当。
英文摘要 Abstract
BACKGROUND: Patient outcomes after revision hip arthroscopy are less favorable than those after primary procedures. Advancements in arthroscopic techniques including labral reconstruction and capsular plication have improved anatomic restoration of the suction seal and capsule. The effect of these techniques on outcomes remains unclear when compared with earlier techniques.
PURPOSE: To compare postoperative outcomes between patients undergoing modern revision (MR) hip arthroscopy techniques and those treated with older methods.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: A prospectively collected surgical database was reviewed for patients undergoing revision hip arthroscopy with a minimum 2-year follow-up. Patients were categorized into an older revision (OR) cohort or MR cohort based on available surgical techniques. Patients in the OR cohort did not have a capsular repair or labral reconstruction with the knotless pull-through technique, while all patients in the MR cohort had capsular closure or plication as well as labral restoration with either repair or modern reconstruction. A 1:1 age, sex, and body mass index propensity match was performed, and patient demographics along with pre- and postoperative radiographic data and outcomes were analyzed. The primary outcome was the rate of conversion to arthroplasty or revision arthroscopy at the 2-year time point. Secondary outcomes included patient-reported outcome scores (PROs) and achievement of clinically relevant outcome thresholds.
RESULTS: A total of 53 patients in the MR cohort were matched with 53 patients in the OR cohort. There were no significant preoperative demographic or radiographic differences between the 2 groups. Patients in the MR cohort had higher levels of acetabular chondral damage identified intraoperatively according to the Outerbridge and acetabular labrum articular disruption classifications (
CONCLUSION: Patients undergoing revision hip arthroscopy with modern techniques had greater postoperative PRO scores compared with revisions with older techniques. Notably, this improvement in outcomes was observed despite higher rates of cartilage damage identified intraoperatively in the modern group.
中文总结
该研究探讨了现代关节镜技术对髋关节翻修手术临床疗效的影响。研究纳入接受翻修髋关节镜手术的患者，依据手术技术分为早期翻修组和现代翻修组，现代翻修组采用labral重建和囊性修复技术以实现解剖复位和 suction seal 重建。结果显示现代翻修组患者在术后功能和患者报告结局指标上均获得显著改善，且翻修手术和全髋关节置换的转换率显著低于早期翻修组。该研究表明，Labral重建和囊性修复等现代技术可改善翻修髋关节镜的预后，为不可修复的盂唇损伤和严重软骨病变患者提供了更优的治疗策略。
英文摘要 Abstract
BACKGROUND: Labral reconstruction demonstrates promising short- and midterm benefits for irreparable labral tears, but long-term outcomes remain understudied.
PURPOSE: To evaluate minimum 10-year patient-reported outcomes (PROs) of primary arthroscopic labral reconstruction compared with a propensity-matched control group.
STUDY DESIGN: Cohort study; Level of evidence, 2.
METHODS: Data were prospectively collected for all patients who underwent primary arthroscopic labral reconstruction with allograft as treatment for femoroacetabular impingement and labral tears. Patients included had preoperative and 10-year minimum postoperative data for PROs. Patients were propensity-matched to a control group that had undergone primary labral repair in a 1:3 ratio based on age, sex, body mass index, and acetabular Outerbridge grade. Patient characteristics and PROs were reported and compared between the groups. Rates of meeting clinically relevant thresholds, secondary arthroscopy, and survivorship were also compared.
RESULTS: A total of 22 hips (22 patients) of 27 eligible hips (81%) that underwent primary labral reconstruction (RECON) were matched to 66 hips (63 patients) that underwent primary repair (REPAIR). Both groups had similar preoperative and postoperative scores for all PROs (
CONCLUSION: Primary labral reconstruction demonstrated favorable outcomes at a minimum 10-year follow-up. When compared with a propensity-matched control group that underwent primary labral repair, both groups achieved similar postoperative PRO scores. Additionally, they met clinically meaningful thresholds and underwent secondary procedures at comparable rates.
中文总结
该研究评估了关节镜下初级盂唇重建手术的10年最小随访临床结局。研究纳入因盂唇损伤接受关节镜盂唇重建的患者，以倾向性匹配的方式与接受盂唇修复的患者进行对照分析。主要评价指标包括患者报告结局评分以及是否需要二次关节镜手术或全髋关节置换转换。结果显示，盂唇重建组在10年随访时各项功能评分均显著改善，且与盂唇修复组在功能评分、临床重要差异达成率和二次手术率方面无统计学显著差异。该研究表明，关节镜盂唇重建术在长期随访中展现了良好的临床效果，可作为盂唇不可修复损伤的有效治疗选择。
英文摘要 Abstract
BACKGROUND: The fragility index has been utilized in the literature to better characterize the limited categorical interpretation of the traditional
PURPOSE/HYPOTHESIS: The purpose was to characterize the rCFI of statistically nonsignificant results in RCTs comparing capsular repair versus noncapsular repair in hip arthroscopy for the treatment of FAIS. It was hypothesized that (1) nonsignificant differences in clinical outcomes between the capsular closure and noncapsular closure groups would be statistically robust, as demonstrated by rCFI values exceeding the rate of loss to follow-up, and (2) rCFI would be greater than traditional rFI values and CFI values reported in the sports medicine literature.
STUDY DESIGN: Meta-analysis; Level of evidence, 2Methods:The PubMed, Cochrane, and Embase databases were queried from inception to October 2024 with combinations of the following search terms: "hip arthroscopy," "capsule, "capsular," and "randomized controlled trials." Studies were included if they were randomized trials that compared capsular closure with nonclosure and had at least 1 nonsignificant outcome reported. The rCFI calculation was performed on primary nonsignificant outcomes across all studies to obtain a mean rCFI. Multivariate linear regression was performed to determine study characteristics and variables associated with higher rCFI values.
RESULTS: Six studies with 416 patients were included in this analysis. A total of 136 outcomes with nonsignificant results were identified across 6 studies, with 6 of these outcomes representing each study's primary outcome. The mean rCFI across all studies was 16.333 (SD, 6.121). A mean of 11.03% (SD, 5.79%) of patients were lost to follow-up. The rCFI exceeded the number of patients lost to follow-up for all analyzed studies. Multivariate regression showed that sample size was significantly predictive of high rCFI (
CONCLUSION: Provisional assessment of rCFI suggests that the nonsignificant differences reported by RCTs comparing hip capsular closure versus nonclosure after interportal capsulotomies are relatively robust. Increased sample sizes in RCTs are associated with greater robustness of nonsignificant results.
中文总结
该研究采用反向连续脆弱性指数对髋关节镜手术中囊膜闭合与未闭合的随机对照试验进行统计分析。脆弱性指数是评估临床试验结果稳健性的重要指标，研究者计算了各研究中非显著性结局的反向连续脆弱性指数值，并分析其与失访率的关系。结果显示，所有分析研究的反向连续脆弱性指数均超过失访患者数量，表明在髋关节镜中比较囊膜闭合与未闭合的临床研究结果具有良好的统计稳健性。该研究为临床医生在解读相关文献时提供了方法学参考，并强调了充分随访在髋关节镜临床研究中的重要性。
英文摘要 Abstract
BACKGROUND: Age has been shown to play a role in patient outcomes after hip arthroscopy for the treatment of femoroacetabular impingement syndrome (FAIS), but little is known regarding this relationship in the population with borderline dysplasia.
PURPOSE: To compare patient outcomes and reoperation rates in patients aged ≥40 years and <40 years with borderline hip dysplasia (BHD) undergoing hip arthroscopy for FAIS at 2- and 5-year follow-up.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: Patient-reported outcomes (PROs) were acquired preoperatively and at 2 and 5 years postoperatively for patients undergoing surgery between January 2012 and June 2019. PROs included the Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Subscale (HOS-SS), modified Harris Hip Score, and visual analog scale for pain and satisfaction. Clinically significant outcomes included the minimal clinically important difference and Patient Acceptable Symptom State (PASS). Patients diagnosed with BHD (lateral central-edge angle, 18°-25°) were stratified into cohorts ≥40 and <40 years old. Older patients were propensity matched 1:1 to younger patients controlling for sex, body mass index (BMI), and acetabular cartilage grade. PROs, clinically significant outcomes, and survivorship were compared between groups.
RESULTS: Ninety-three patients aged ≥40 years with BHD (mean ± SD age, 48.4 ± 5.7 years; 68.8% female; BMI, 26.6 ± 5.3 kg/m
CONCLUSION: This study concludes that patients with BHD aged ≥40 years treated with contemporary hip arthroscopy for FAIS achieved similar function, pain, and satisfaction at 5-year follow-up but worse sports function and sports-related PASS achievement when compared with patients with BHD aged <40 years. Furthermore, while patients ≥40 years old had a higher rate of total hip arthroplasty conversion, they demonstrated similar overall reoperation rates as compared with younger patients at 5 years.
中文总结
该研究比较了40岁及以上与40岁以下边缘发育不良患者接受髋关节镜治疗股髋撞击综合征的临床结局。研究纳入了接受初次髋关节镜手术的边缘发育不良患者，依据年龄进行分组并通过倾向性评分匹配控制混杂因素。主要评价指标包括患者报告结局评分、临床重要差异达成率以及再次手术率。结果显示，两组患者在术后功能和疼痛改善方面无显著差异，但40岁及以上组在运动功能评分和运动相关PASS达成率方面表现较差。此外，老年组全髋关节置换转换率较高，但总体再手术率相似。该研究表明年龄因素对边缘发育不良患者髋关节镜预后有一定影响，但并非手术禁忌证。
英文摘要 Abstract
BACKGROUND: Master athletes (MAs), defined as those aged ≥35 years actively participating in sports, have demonstrated superior short-term outcomes and reoperation-free survivorship after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) compared with nonathletic counterparts; however, their mid- and long-term outcomes remain unclear.
PURPOSE/HYPOTHESIS: The purpose was to evaluate patient-reported outcomes (PROs), achievement of clinically significant outcomes (CSOs), and reoperation-free survivorship at long-term follow-up after primary HA for FAIS in MAs in comparison with a propensity-matched control group of nonmaster athletes (NMAs), defined as those aged ≥35 years who denied weekly sports activity. We hypothesized that MAs would demonstrate superior PROs, CSO achievement, and reoperation-free survivorship compared with NMAs.
STUDY DESIGN: Cohort study, Level of evidence, 3.
METHODS: Patients with minimum weekly preoperative sports participation aged ≥35 years who underwent HA for FAIS between January 2012 and October 2014 with long-term follow-up were propensity-matched 1:1 to patients aged ≥35 years who denied weekly preoperative sports participation, controlling for age, sex, and body mass index (BMI). PROs collected preoperatively and at 2-, 5-, and 10-year follow-up time points included the Hip Outcome Score-Activities of Daily Living (HOS-ADL) and Hip Outcome Score-Sports Subscale (HOS-SS), 12-item International Hip Outcome Tool (iHOT-12) score, modified Harris Hip Score (mHHS), and visual analog scale scores for pain and satisfaction. Cohort-specific minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) thresholds were compared. Survivorship was compared using Kaplan-Meier analysis.
RESULTS: In total, 70 MAs were matched to 70 NMAs. Patient characteristics were similar between MAs and NMAs, including age (44.89 ± 7.7 vs 45.77 ± 6.9 years;
CONCLUSIONS: MAs undergoing primary HA for FAIS achieve comparable PROs, CSOs, and reoperation-free time-dependent survivorship to NMAs at long-term follow-up.
中文总结
该研究评估了优秀运动员（定义为35岁及以上积极参与运动者）接受髋关节镜治疗股髋撞击综合征的长期临床结局。研究纳入了10年随访数据，比较优秀运动员与非运动员患者在功能评分、临床重要差异达成率和无再手术生存率方面的差异。结果显示，优秀运动员组在术前和术后各时间点的功能评分均优于非运动员组，但两组的功能改善幅度相似。优秀运动员组在临床阈值达成率和无再手术生存率方面表现更佳，表明运动参与状态可能作为预后良好的预测因素。该研究为运动员群体接受髋关节镜治疗的长期疗效提供了循证依据。
英文摘要 Abstract
BACKGROUND: The chondrolabral junction (CLJ) plays an important role in maintaining hip dynamics, and there is a paucity in the literature examining the effect of CLJ breakdown on long-term outcomes after hip arthroscopy.
PURPOSE: To identify patient-reported outcomes (PROs), achievement of clinically significant outcomes, and reoperation rates at 10-year follow-up in patients with severe CLJ breakdown undergoing hip arthroscopy for femoroacetabular impingement.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHODS: PROs were obtained preoperatively and at 10-year follow-up for patients undergoing surgery between January 2012 and June 2014. PROs included the Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Subscale, modified Harris Hip Score, international Hip Outcome Tool-12, and visual analog scale for pain. Clinically significant outcomes included the minimal clinically important difference and Patient Acceptable Symptom State. Patients were categorized as having severe CLJ breakdown if their Beck classification was between 3 and 4 and mild if their classification was 1 to 2. Those with severe breakdown were propensity matched 1:1 to patients who had mild breakdown, controlling for age, sex, and body mass index (BMI). Independent
RESULTS: In this study, 53 patients with severe CLJ breakdown (25 females; mean ± SD age, 38.6 ± 12.2 years; BMI, 25.9 ± 4.9 kg/m
CONCLUSION: Patients with severe CLJ junction breakdown undergoing hip arthroscopy for femoroacetabular impingement achieve similar PROs at long-term follow-up but undergo hip arthroplasty significantly more often when compared with patients with mild breakdown.
中文总结
该研究探讨了严重软骨盂唇连接处损伤对髋关节镜预后的10年影响。研究将患者分为严重软骨盂唇连接处损伤组和轻度损伤组，分析两组患者报告结局评分、临床重要差异达成率和全髋关节置换转换率的差异。结果显示，严重损伤组与轻度损伤组在10年功能评分改善方面无显著差异，但严重损伤组全髋关节置换转换率显著高于轻度损伤组。该研究表明，软骨盂唇连接处损伤严重程度是影响髋关节镜术后是否需要关节置换的重要因素，但并不决定患者的功能恢复程度，提示盂唇重建等保留手术对严重损伤患者仍具有价值。
英文摘要 Abstract
BACKGROUND: Obesity is a recognized adverse prognostic factor across various surgical interventions.
PURPOSE: To evaluate long-term outcomes in patients with obesity who underwent hip arthroscopy for femoroacetabular impingement (FAI) and labral tears, compared with a control group with normal weight.
STUDY DESIGN: Retrospective cohort study; Level of evidence, 3.
METHODS: This was a prospectively matched cohort study. Data were analyzed for patients who underwent primary hip arthroscopy for FAI and labral tears between October 2008 and October 2013, with a body mass index (BMI) of ≥30 kg/m
RESULTS: A total of 266 patients were included in the study, with a mean follow-up time of 125.19 ± 43.07 months. The 2 groups demonstrated similar magnitudes of improvement at 10-year follow-up for the Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), and visual analog scale for pain (VAS-Pain), achieving comparable postoperative scores. The 2 groups achieved the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for the modified Harris Hip Score (mHHS), NAHS, and HOS-SSS at similar rates (
CONCLUSION: Hip arthroscopy for the treatment of FAI and labral tears in patients with obesity yielded significant and sustainable long-term improvements, which were equivalent to those of a benchmark matched control group of normal-weight patients. However, patients with obesity had >2-fold odds of conversion to THA. Patients with morbid obesity achieved clinical thresholds at lower rates and should therefore be approached with caution.
中文总结
本研究旨在评估肥胖患者接受髋关节镜手术治疗股髋撞击综合征（FAI）及盂唇撕裂的十年功能结局，并与正常体重对照组进行比较。研究纳入了2008年10月至2013年10月期间接受初次髋关节镜手术的266例患者，平均随访时间为125.19个月。结果显示，肥胖组与正常体重组在十年随访时非关节炎髋关节评分（NAHS）、运动亚量表（HOS-SSS）及疼痛视觉模拟量表（VAS）的改善幅度相当，术后评分也无显著差异。两组在改良Harris髋关节评分（mHHS）、NAHS和HOS-SSS达到最小临床重要差异（MCID）及患者可接受症状状态（PASS）的比例相似。然而，肥胖患者全髋关节置换术（THA）的转换风险增加超过两倍，尤其是病态肥胖患者达到临床阈值的比例更低，应谨慎评估。该研究结论认为，髋关节镜手术治疗FAI和盂唇撕裂在肥胖患者中可获得显著且持久的长期改善，效果与正常体重患者相当，但需注意肥胖对关节置换转换率的不良影响。
英文摘要 Abstract
BACKGROUND: Periacetabular osteotomy (PAO), concomitant with hip arthroscopy, used as treatment for symptomatic hip acetabular dysplasia, has shown favorable outcomes at midterm follow-up. However, limited literature has evaluated outcomes and return to sport (RTS) rates in athletes with concomitant PAO and hip arthroscopy.
PURPOSE/HYPOTHESIS: The purpose of this study was to analyze functional outcomes and RTS rates of athletes who underwent PAO with concomitant hip arthroscopy for symptomatic hip dysplasia with a minimum 5-year follow-up. It was hypothesized that athletes undergoing PAO with concomitant hip arthroscopy would show favorable outcomes and high rates of RTS.
STUDY DESIGN: Case series; Level of evidence, 4.
METHODS: Retrospectively analyzed data for all patients who underwent PAO concomitant with hip arthroscopy as treatment for painful hip dysplasia between November 2010 and December 2018. Included patients reported sports participation and had completed preoperative and a minimum of 5-year postoperative questionnaires for at least 1 of the following patient-reported outcomes (PROs): the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12), visual analog scale (VAS) for pain, and patient satisfaction, or had a documented endpoint during the study timeframe. Clinically important thresholds were included in the analysis. An overall RTS analysis was conducted, and continuation of sport was analyzed at a minimum of 5 years postoperatively.
RESULTS: A total of 28 patients (n = 29 hips) were included. Patients experienced significant improvements in mHHS, NAHS, HOS-SSS, iHOT-12, and VAS scores, and reported high patient satisfaction. A high percentage of patients reached the minimal clinically important difference for the evaluated PROs and reported a positive response to the patient acceptable symptom state anchor question. Of the 28 patients, 3 chose to stop playing due to lifestyle changes or loss of interest in the sport, 3 stopped because of a desire to prevent hip symptoms, and 1 stopped because of a doctor's recommendation. Among the remaining 21 patients who attempted to RTS, 18 (85.7%) returned to sports at some time postoperatively. Three patients (14.3%) did not return due to persistent hip symptoms. Moreover, of those who returned to sport, 14 (77.8%) continued to play for a minimum of 5 years postoperatively. Four hips (13.8%) required revision hip arthroscopy, and 1 (3.4%) underwent conversion to total hip arthroplasty.
CONCLUSION: PAO with concomitant hip arthroscopy for symptomatic hip dysplasia resulted in significant improvements in functional outcomes, with a high percentage of patients achieving important clinical thresholds. There was a high rate of RTS, enabling a substantial number of patients to continue playing at a minimum 5-year follow-up.
中文总结
本研究回顾性分析了运动员接受髋臼周围截骨术（PAO）同期行髋关节镜手术治疗症状性髋关节发育不良的功能结局及运动重返率。纳入2010年11月至2018年12月期间接受PAO同期髋关节镜手术的28例患者（29髋），所有患者均报告有运动参与史，并完成至少5年术后功能评估。结果显示，患者在改良Harris髋关节评分、非关节炎髋关节评分、运动亚量表、国际髋关节预后工具-12及疼痛视觉模拟量表方面均获得显著改善，且报告较高的患者满意度。绝大多数达到各项评分体系的最小临床重要差异阈值。在运动重返方面，28例患者中21例尝试重返运动，其中18例（85.7%）成功返回，14例（77.8%）持续运动至少5年。3例因生活方式改变或兴趣丧失停止运动，3例因持续髋关节症状未能返回，另有1例因医师建议停止。随访期间4髋（13.8%）接受翻修手术，1髋（3.4%）转换为全髋关节置换术。研究表明，PAO同期髋关节镜手术治疗髋关节发育不良可获得良好的功能预后，运动员运动重返率高，多数患者能够长期维持运动状态。
英文摘要 Abstract
AIMS: Hip arthroscopy is the treatment of choice for patients with femoroacetabular impingement (FAI), and it has been shown that outcomes are dependent upon symptom duration. However, the relationship between symptom duration and intra-articular injury pattern at time of arthroscopy has not previously been studied.
METHODS: A retrospective review was conducted of all patients undergoing hip arthroscopy for FAI between January 2017 and December 2023, who were identified from the institutional database of Queen Elizabeth University Hospital, Glasgow, a tertiary referral, university-affiliated hospital. Times from referral and review to surgery, patient demographics, and intraoperative findings (Beck and University College London Hospitals (UCLH) classifications) were assessed. Multivariate and univariate linear regression analyses were performed to determine if there was a correlation between severity of cartilage injury and waiting time or patient demographics.
RESULTS: A total of 307 patients were eligible for inclusion. The mean age was 34 years (SD 9.2) and mean BMI 26.6 kg/m
CONCLUSION: Increasing waiting times are resulting in increased severity of intra-articular damage in patients undergoing hip arthroscopy for FAI. For the first time, longer waiting times have been correlated with worse cartilage injuries, independent of the size of the cam lesion, particularly in male patients.
中文总结
本研究探讨股髋撞击综合征（FAI）患者从转诊到手术的等待时间与关节内软骨损伤严重程度之间的关系。研究回顾性分析了2017年1月至2023年12月期间在英国格拉斯哥伊丽莎白女王大学医院接受髋关节镜手术的307例患者，收集从转诊、门诊到手术的时间间隔、患者人口学特征及术中关节软骨损伤评估数据（采用Beck分类和UCLH分类）。多因素及单因素回归分析结果表明，等待时间延长与更严重的软骨损伤呈显著正相关，这一关系独立于cam病变大小之外，尤其在男性患者中更为突出。研究还发现平均等待时间与软骨损伤严重程度之间存在直接相关性。结论强调，当前日益延长的手术等待时间正在导致FAI患者接受关节镜手术时关节内损伤程度加重，这一发现对临床资源配置和治疗时机选择具有重要参考价值，提示应优先处理FAI患者以避免不可逆的软骨损伤发生。
英文摘要 Abstract
BACKGROUND: Developmental dysplasia of the hip (DDH) is a common pediatric orthopedic condition. Caregivers of children with DDH often face significant challenges that may affect their quality of life. This review aimed to systematically identify, appraise, summarize the available qualitative evidence on caregivers' experiences of caring for children with DDH. METHODS: We systematically searched eight databases (Embase, Cochrane Library, Web of Science, PubMed, CINAHL, PsycINFO, ERIC, and ProQuest) from inception to May 2025. Two researchers independent screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal checklist for qualitative research. A meta-aggregative approach was used to categorize and summarize themes reported in the primary studies. Confidence in each summary finding was assessed using GRADE-CERQual. RESULTS: Eight studies met the inclusion criteria. These included four interview-based studies (total 66 participants) and four survey-based studies with open-ended questions (total 1,522 participants). Four main themes were identified: (1) a challenging and often delayed diagnostic process; (2) treatment devices complicate daily parenting tasks; (3) inadequate or ill-timed informational and practical support; and (4) gradual adaptation and skill development over time. CONCLUSION: Caregivers of children with DDH face substantial challenges during diagnosis, treatment, and daily care. The findings highlight the potential value of timely, practical, and empathetic support that addresses informational needs and acknowledges the adaptive work families undertake. Future research should employ more in-depth qualitative designs to capture the nuanced processes of caregiver adaptation.
中文总结
本篇为《临床骨科与相关研究》杂志的CORR Insights评论文章，针对青少年股髋撞击综合征（FAI）关节镜治疗后短期蹲姿生物力学的原始研究进行点评。该评论指出，青少年FAI患者术后蹲姿力学变化的研究具有重要的临床意义，因为FAI患者在术前常表现出与正常人群不同的蹲姿适应性改变，而手术干预是否能够纠正这些异常力学模式尚不明确。评论强调，青少年人群的骨骼发育特点使得术后康复评估更为复杂，需要综合考虑关节活动度、肌肉力量、神经肌肉控制及功能恢复等多维度指标。该评论建议临床医师在评估青少年FAI手术效果时，不仅应关注影像学改变和患者报告结局指标，还应重视客观生物力学参数的改善情况，以更全面地评价手术对患者日常功能和运动表现的影响，为个体化康复方案制定提供依据。
英文摘要 Abstract
BACKGROUND: Femoroacetabular impingement (FAI) results from overcoverage of the acetabulum or excess bone on the femoral head-neck junction, which may cause pain or discomfort with repetitive hip flexion. Previous studies have reported adaptations in squat mechanics in individuals with FAI compared with controls, but to our knowledge, there has been little research exploring pre- to postoperative deviations in adolescents.
QUESTIONS/PURPOSES: (1) Does surgical treatment result in measurable improvements in maximum squat depth? (2) Does surgical intervention alter the individual's balance control strategy during squatting? (3) Are there kinematic changes at specific movement milestones within the squat cycle after surgery? (4) Does the overall squat strategy, encompassing the entire movement, exhibit postoperative changes?
METHODS: A retrospective analysis was conducted of patients enrolled between February 2016 and July 2023 in a large prospective study evaluating lower extremity biomechanical outcomes after various hip surgeries. Sixty hips were identified meeting specific criteria: (1) absence of neurological or syndromic abnormalities, (2) diagnosis of symptomatic idiopathic FAI through radiographic assessment, (3) scheduled for arthroscopic hip preservation surgery performed by one orthopaedic surgeon, and (4) tested in our motion capture lab before surgery. Of the 60, patients with bilateral symptomatic FAI were excluded as were those who had undergone previous surgical treatment, leaving 43 patients. In all, 79% (34 of 43) of patients completed the target squat that was analyzed in this study, and 65% (22 of 34) of patients completed the same task at their postoperative visit 8 to 16 months after surgery. Sagittal plane segment and joint angles as well as foot progression angle were analyzed across the squat cycle at four key movement milestones: maximum squat depth, preoperative maximum squat depth, maximum pelvic tilt, and maximum hip flexion. Pelvic tilt and hip flexion were plotted versus squat depth and versus each other throughout the squat task with the area between the descent and ascent curves calculated to quantify motion in the sagittal plane.
RESULTS: Median (range) maximum squat depth (preoperative 27 [13 to 38] versus postoperative 28 [17 to 40], median difference 1 [95% CI 1 to 5]; p = 0.02) increased postoperatively. Balance control strategies showed minimal changes, as the only notable difference was increased trunk flexion during the postoperative squat (preoperative 44 [6 to 65] versus postoperative 47 [18 to 74], median difference 3 [95% CI 1 to 13]; p = 0.01). Increased knee flexion was observed at both the maximum squat depth (preoperative 112 [71 to 135] versus postoperative 117 [78 to 144], median difference 5 [95% CI -1 to 14]; p = 0.02) and maximum hip flexion (preoperative 112 [71 to 132] versus postoperative 117 [78 to 144], median difference 5 [95% CI -1 to 14]; p = 0.02) positions. Pelvic tilt, hip flexion, and foot progression angles demonstrated no differences at the maximum squat depth, maximum pelvic tilt, or maximum hip flexion positions during the squat. Median (range) sagittal plane ROM increased for the trunk (preoperative 43 [16 to 66] versus postoperative 52 [25 to 75], median difference 9 [95% CI 2 to 16]; p = 0.01), pelvis (preoperative 24 [13 to 37] versus postoperative 27 [15 to 44], median difference 3 [95% CI 1 to 7]; p = 0.02), hip (preoperative 98 [76 to 116] versus postoperative 103 [89 to 130], median difference 5 [95% CI 0 to 8]; p = 0.046), and knee (preoperative 112 [73 to 141] versus postoperative 124 [87 to 152], median difference 12 [95% CI 3 to 15]; p = 0.02).
CONCLUSION: Based on these findings, the squat task could be used as a functional tool for clinicians to quickly assess a patient's abilities before and after surgical treatment. Future research should explore longitudinal studies to assess biomechanical changes over time and to consider whether standardized postoperative rehabilitation in adolescents alters the squat pattern for patients with FAI.
LEVEL OF EVIDENCE: Level III, therapeutic study.
中文总结
本研究旨在评估青少年股髋撞击综合征（FAI）患者接受关节镜手术治疗后蹲姿生物力学的短期改变。研究回顾性分析了2016年2月至2023年7月期间接受前瞻性研究评估的患者，60髋符合入组标准，排除双侧症状及既往手术患者后，最终34例患者完成目标蹲姿动作分析，其中22例同时完成术后8至16个月的随访评估。研究采用运动捕捉实验室分析矢状面节段及关节角度变化，在四个关键运动时相点进行评估：最大蹲深度、术前最大蹲深度、最大骨盆倾斜及最大髋关节屈曲。结果显示，术后最大蹲深度较术前显著增加（中位数差1度），仅观察到躯干屈曲轻度增加（3度），平衡控制策略总体无显著改变。膝关节屈曲在最大蹲位及最大髋屈位置均观察到术后改善，而骨盆倾斜及髋关节屈曲的整体运动模式未发生显著变化。该研究为青少年FAI患者关节镜术后蹲姿变化的首次报道，提示手术治疗可带来可测量的生物力学改善，尤其体现在蹲姿深度增加和下肢运动学优化方面，为青少年FAI的手术疗效评估提供了新的客观指标。