髋关节镜术治疗髋臼盂唇囊肿△

Hip arthroscopy for treatment of acetabular paralabral cyst

摘要:

［目的］ 探讨关节镜治疗髋关节盂唇囊肿的临床效果。［方法］ 2016 年 1 月—2018 年 10 月，对 16 例盂唇囊肿患者行髋关节镜手术治疗，评价临床与影像结果。［结果］ 术中镜下证实 16 例患者均存在盂唇囊肿，14 例存在凸轮型股骨髋臼撞击（femoroacetabular impingement, FAI），占 87.50%。所有患者均行囊肿切开清除盂唇缝合术，对存有 FAI 的患者行凸轮骨赘切除成形，术中无严重并发症。16 例患者术后随访 24 个月以上。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 角显著减少（P<0.05），而 FHNO 显著增加 （P<0.05），LCEA 无显著变化 （P>0.05）。至末次随访时，16 例患者影像检查均未见盂唇囊肿复发，髋关节无明显退变。［结论］髋关节镜手术是治疗髋关节盂唇囊肿的有效手段，可显著改善患者的髋关节症状和功能。

Abstract:

[Objective] To investigate the clinical outcomes of hip arthroscopy for treatment of acetabular paralabral cyst. [Methods] From January 2016 to October 2018, a total of 16 patients underwent hip arthroscopy for acetabular paralabral cyst, and their clinical and imaging data were evaluated. [Results] During arthroscopy, all the 16 patients proved of acetabular paralabral cyst, and 14 cases of them had cam-type femoroacetabular impingement (FAI) found, accounting for 87.5%. All patients underwent cysts resection and labral suture, and those with FAI underwent cam osteophyte resection. The 16 patients had no serious complications, and were followed up for more than 24 months. The VAS scores were significantly decreased (P＜0.05) , while 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 increased (P＜0.05) , and there was no significant change in LCEA (P＞0.05) postoperatively compared with those before operation. Up to the latest follow-up, nobody of them had recurrence of labral cysts and obvious hip degeneration found on images. [Conclusion] Hip arthroscopy is an effective method for the treatment of ace- tabular paralabral cyst, which does significantly improve the symptoms and function of the hip.