髋关节镜术治疗中青年髋关节盂唇钙化△

Hip arthroscopy for treatment of labral amorphous calcification in young and middle-aged adults

摘要:

［目的］ 评估关节镜技术治疗髋关节盂唇钙化的临床结果。［方法］ 2015 年 1 月—2018 年 10 月，15 例行影像发现盂唇钙化患者纳入本研究，均行髋关节镜术治疗。评估患者临床与影像资料。［结果］术中镜下检查见盂唇钙化病灶位于髋臼前或上方 11-3 点位置。病变体积与术前 VAS 评分呈显著正相关（P<0.05），与术前 mHHS 和 iHOT-12 评分呈显著负相关（P< 0.05）。15 例患者中，5 例伴钳夹型，2 例伴凸轮型，5 例伴混合型 FAI，单纯盂唇钙化仅 3 例。与术前相比，术后 12 个月和 24 个月 VAS 评分显著下降（P<0.05），而 mHHS 和 iHOT-12 评分均显著增加（P<0.05）。影像方面，与术前相比，术后 α 角和 LCEA 均显著减少 （P<0.05），而 FHNO 显著增加 （P<0.05）；15 例患者影像检查均未见盂唇钙化复发，髋关节无明显退变。 ［结论］髋关节镜手术是治疗髋关节盂唇钙化的有效手段。钙化大小是术前症状及功能的影响因素之一。

Abstract:

[Objective] To evaluate the clinical outcome of hip arthroscopy for labral amorphous calcification. [Methods] From January 2013 to October 2017, 15 patients who was diagnosed of labral amorphous calcification on images were enrolled in this study, and all re- ceived hip arthroscopy. The clinical and imaging data of the patients were evaluated. [Results] Intraoperatively, arthroscopic examination showed that the calcified lesion of labrum was located at 11-3 clock points in front or above the acetabulum. The lesion volume was signifi- cantly positively related to the preoperative VAS score (P＜0.05) , whereas significantly negatively related to the preoperative mHHS and iHOT-12 scores (P＜0.05) . Among the 15 patients, 5 case were associated with pincer- type impingement, 2 with cam- type FAI, 5 with mixed FAI, and only 3 were simple labral calcification. The VAS scores significantly decreased (P＜0.05) , while the mHHS and iHOT-12 scores significantly increased at 12 and 24 months postoperatively compared with those before surgery (P＜0.05) . Radiographically, the α angle and lateral center edge angle (LCEA) significantly reduced (P＜0.05) , while the femoral head neck offset (FHNO) significantly in- creased after surgery compared with those preoperatively (P＜0.05) . No recurrence of labral calcification, and no obvious hip degeneration were seen in anyone of the 15 patients. [Conclusion] Hip arthroscopy is an effective method for the treatment of labral amorphous calcifica- tion. The size of calcification lesion might be one of the influencing factors of preoperative symptoms and function.