Inside-out和Outside-in髋关节镜技术治疗股骨髋臼撞击征的疗效对比研究

目的:对比分析两种髋关节镜技术治疗股骨髋臼撞击征(femoroacetabular impingement,FAI)的临床疗效和并发症.方法:回顾性分析2016年6月至2019年6月采用髋关节镜手术治疗并获得随访的48例FAI患者.根据手术方式的不同分为两组,Inside-out组,由中央到外周;Outside-in组...

Clinical outcomes of hip arthroscopic treatment for femoroacetabular impingement: a comparative study between Inside-out and Outside-in approach

Objective: To compare the clinical outcomes and complications of hip arthroscopic treatment for femoroacetabular impingement (FAI) performed with either Inside-out or Outside-in approach.Methods: The clinical date of 48 patients with FAI treated by hip arthroscopy surgery and follow-up from June 2016 to June 2019 were retrospectively analyzed. According to the different operative methods,the patients were divided into two groups. Inside-out group,from central compartment to peripheral compartment;Outside-in group,from peripheral compartment to central compartment. There were 14 males and 10 females in Inside-out group with an average age of (39.8±7.6)years old,13 males and 11 females in Inside-out group with an average age of (39.5±9.1)years old in Outside-in group. There was no significant difference in age,gender,body mass index,side,impingement type,medical history and follow-up time between the two groups. The complication occurrence rate,modified Harris hip score(mHHS)and nonarthritic hip score(NAHS) were compared between these two groups.Results: The mHHs and NAHS scores of the two groups were significantly higher than those before operation,but there was no significant difference between the two groups(P>0.05). In the Inside-out group,there were 4 cases of nerve traction injury and 3 cases of iatrogenic injury,while only 1 case of nerve traction injury occurred in the Outside-in group. The incidence of complications in the inside out group was higher than that in the outside in group(16.7% vs 4.2%, χ²=5.400,P=0.020).Conclusion: Both hip arthroscopic surgery methods can obtain satisfactory clinical efficacy in the treatment of FAI,but the incidence of postoperative complications of Outside-in surgical method is lower. The out-side in method can be preferentially selected for the patients with the indications of operation.