A clinical observational study on patient-reported outcomes,hip functional performance and return to sports activities in hip arthroscopy patients

ObjectivesTo describe data of short- and midterm results of hip arthroscopy patients based on patient-reported hip function, hip functional performance and return to sports activities.DesignObservational cohort study.SettingSports medical center.Participants37 recreational athletes (21 men) at least six months after finishing rehabilitation for hip arthroscopy.Main outcome measuresInternational Hip Outcome Tool 33 (IHOT-33), Pain Visual Analogue Scale (VAS), Global Perceived Effect Scale (GPE), sports questionnaires and hip functional performance tests.ResultsAt a mean follow-up time of 2.3 years, 81% of participants reported improvement on the GPE and 84% returned to sports activities. The mean IHOT-33 score was 69.3; the mean VAS score was 35.0. Range of motion (ROM) and strength were within the 90% Limb Symmetry Index (LSI) limit, except for hip internal rotation ROM. A full recovery of hip functional performance, as measured with balance and hop tests, was established based on the 90% LSI limit.ConclusionsThe overall short- and midterm results of these follow-up data show good recovery of hip arthroscopy patients on patient-reported outcomes, functional performance and return to sports activities. The functional performance tests used in this study seem adequate for measuring recovery in hip arthroscopy patients.     

Arthroscopic glenoid retrieval in failed TSA: Search and rescue

Aseptic loosening of the glenoid is one of the most common reasons for revision surgery. Radiographs often demonstrate lucencies, of which only a small percentage are clinically significant. Diagnosing a loose glenoid can therefore be extremely challenging. Arthroscopy may be used to diagnose and remove the polyethylene in select patients where revision surgery is contraindicated. Results demonstrate acceptable outcomes and clinically significant improvements in preoperative pain and function.     

髋关节镜下治疗髋关节撞击综合征的围手术期护理干预

目的探讨髋关节镜下治疗髋关节撞击综合征患者的围手术期护理干预效果。方法选取2014年3月~2016年12月期间我院收治的髋关节镜下治疗髋关节撞击综合征的患者117例,将其按照随机数字表法分为对照组和观察组,对照组应用常规护理干预,观察组应用围手术期护理干预,观察两组的Harris髋关节评分、α角度、并发症和护理满意度。结果对照组的Harris评分为(77.72±8.31)分,α角度为(49.31±5.38)°,并发症发生率为48.27%,护理总满意率为63.79%;观察组的Harris评分为(91.65±8.64)分,α角度为(33.82±5.83)°,并发症发生率为22.03%,护理总满意率为86.44%,观察组的Harris评分和护理总满意率较对照组高,α角度和并发症发生率较对照组小,两组差异有统计学意义(P0.05)。结论对髋关节镜下治疗髋关节撞击综合征的患者应用围手术期护理干预,能够有效减少患者疼痛,加快患者的恢复,缩小髋关节的α角度,减少并发症的发生率,患者满意度高,值得广泛临床推广。     

A rare case report of vulvar necrotizing fasciitis in a healthy patient

IntroductionNecrotizing fasciitis (NF), a necrotizing infection of the soft tissue, is a medical emergency usually occurring in the lower extremities and abdominal regions and often difficult to diagnose promptly.Presentation of caseThis case report looks at one atypical presentation of NF with the unusual location of the vulva and no known associated comorbidities or risk factors.DiscussionDiagnosing this patient was particularly difficult due to the inconsistent clinical, laboratory and imaging findings. The CT scans and WBC count were indicative of NF, but the LRINEC score was not high enough to make the diagnosis of NF. As a result, we relied on the hemodynamic instability and clinical findings of the physical exam to be strong indicators of NF, and acted on that indication.ConclusionActing quickly on the hemodynamic findings and suspicion as opposed to waiting for a confirmed diagnosis resulted in a good prognosis since immediate surgical debridement is imperative to surviving this acute condition. Despite major advancements in the imaging modalities and the introduction of a laboratory score, our case suggests that the diagnosis still heavily relies on clinical findings, such as hemodynamic instability. Furthermore, our case suggests that NF should be included in the differential regardless of atypical location and lack of common clinical associations.     

关节镜结合开放滑膜切除术治疗膝关节慢性滑膜炎

目的探讨关节镜结合开放滑膜切除术治疗膝关节慢性滑膜炎的手术方法及临床疗效。方法回顾性收集38例膝关节慢性滑膜炎患者的临床资料,其中18例在关节镜结合开放下行膝关节滑膜切除术,20例行全关节镜下滑膜切除术,分析两组患者的临床资料,从手术时间、切口长度、术后疼痛VAS评分、术后引流量、术后住院天数、术后膝关节屈曲活动度、Lysholm功能评分等方面进行比较。结果关节镜结合开放组在手术时间、术后引流量方面低于全关节镜组,在切口长度、术后疼痛VAS评分、术后住院天数方面高于全关节镜组,末次随访时两组膝关节屈曲活动度及Lysholm功能评分无显著性差异。结论关节镜结合开放滑膜切除术能彻底清理膝关节增生的滑膜,且手术操作方便,疗效满意。     

关节镜下跟骨骨刺去除联合带线锚钉固定跖筋膜的研究（附17例报告）

目的探讨关节镜下跟骨骨刺去除联合带线锚钉固定跖筋膜的临床疗效。方法通过对17例符合跟骨骨刺的病例行关节镜下跟骨骨刺去除联合带线锚钉固定跖筋膜进行疗效观察。结果所有病例均得到有效随访,所有患者疼痛均得到有效缓解,X片显示骨刺消除未再生。无切口感染病例,其中5例患者伤口延迟愈合,2例患者切口愈合后负重行走再裂开,细菌培养均阴性。总有效率100.00%,切口正常愈合率70.58%。结论关节镜下跟骨骨刺去除联合带线锚钉固定跖筋膜:(1)创伤小,切口小,2.0 cm左右,出血少;(2)关节镜视野清晰,有效彻底清除病灶,缩短手术时间;(3)缝合跖筋膜,维持、修复了足弓的稳定性;(4)术后恢复快,切口美观,住院时间短。