再次髋关节镜手术的病因和术后髋关节功能性分析

摘要： 摘要：目的？？探讨再次关节镜手术对患者功能的影响，并调查患者满意度，同时评估相关适应证。方法？采用单中心前瞻性无对照研究设计，纳入2011年1月-2014年12月在该院接受再次髋关节镜手术的患者，并对患者进行跟踪随访，中位随访时间为（23.3±2.4）个月。术前和术后随访的髋关节功能评估采用改良Harris评分、WOMAC和Christensen（NaHS）问卷调查表和满意度量表。再次关节镜手术的适应证是指患者出现关节镜手术相关的反复或持续性疼痛。结果 295例初次髋关节镜手术患者中17例（5.8%）患者接受再次髋关节镜手术：男9例，女8例；中位年龄（29.6±6.8）岁。17例接受再次关节镜手术的患者中13例原发病为股骨髋臼撞击综合征患者（包括1例T？nnisⅡ型骨关节炎），3例关节不稳导致的盂唇损伤和1例软骨瘤病变患者；12例持续性疼痛，其中9例来自股骨髋臼撞击综合征；3例手术失败。所有患者髋关节功能评分均有改善，其中WOMAC评分增加（21.7±13.2）分（P <0.05）和NaHS评分提高（32.6±10.7）分（P <0.05）。17例患者中10例对再次关节镜手术表示满意或非常满意（59.0%）。结论 与初次关节镜相比，再次髋关节镜手术功能结局短期内令患者满意；再次关节镜手术的主要原因是治疗不充分导致原发病转为顽固性病变。
Abstract: Abstract: Objective？To investigate the functional results and patient satisfaction following repeated arthroscopy and the relevant indications.？Methods？A single-center continuous prospective study without control group included patients underwent repeated hip arthroscopy between January 2011 and December 2014, with a mean (23.3 ± 2.4) months follow-up. Preoperative and follow-up functional assessment used the modified Harris hip, WOMAC and Christensen (NaHS) questionnaires, and a satisfaction scale. On etiological analysis, repeated arthroscopy was indicated if a cause of recurrent or persistent pain accessible to arthroscopic treatment was identified. ？Results？Seventeen patients were included out of 295 primary arthroscopies (5.8%): 9 males, 8 females; Median age (29.6 ± 6.8). Indications for primary arthroscopy comprised 13 cases of femoroacetabular impingement (including 1case of T？nnis II type osteoarthritis ), 3 labrum lesions with instability and 1 chondromatosis. 12 cases of the 17 primary lesions showed persistence, including 9 cases of femoroacetabular impingement. There were 3 failures in 17 repeated arthroscopies. All functional scores improved, with a gain of (21.7 ± 13.2) points (P < 0.05) on WOMAC score and (32.6 ± 10.7) points (P < 0.05) on NaHS score. Ten of the 17 patients were satisfied or very satisfied with the repeated arthroscopy (59.0%).？Conclusion？Although less good than on primary arthroscopy, functional results on repeated hip arthroscopy were satisfactory in the short term. The main reason for repeated arthroscopy was per-sistence of initial abnormality due to insufficient treatment.