为研究关节镜下带线锚钉缝合修复髋臼盂唇损伤的临床疗效，分析了2012年1月至2017年1月因单纯髋臼盂唇损伤接受关节镜下带线锚钉缝合修复治疗患者的临床资料。手术前后分别对患者体征、疼痛程度、髋关节功能及软骨退变程度进行评价。共获得完整临床资料42份，平均年龄29岁，平均随访时间31个月。患者VAS疼痛评分由术前4.5±0.92降至术后1.6±1.2，髋关节Harris评分由术前56.95±10.6提高至术后95.95±5.4，术后39例Harris评分超过90分，优良率92.8％。术后VAS评分及Harris评分和术前对比差异有统计学意义（P<0.001）。患者术后软骨状况和术前对比差异无统计学意义（P=0.083）。证实髋关节镜下带线锚钉髋臼盂唇缝合修复术效果优良，对于髋臼盂唇损伤具有重要治疗价值。
This paper is a retrospective study of the clinical outcomes of the arthroscopic acetabular labral repair with suture anchor. The clinical data of patients of the arthroscopic repair with wire anchors due to the acetabular labrum tears from January 2012 to January 2017 are retrospectively analyzed. Before and after the surgery, the patients are evaluated for the physical signs, the pain, the hip function and the degree of cartilage degeneration, with a total of 42 sets of complete clinical data, of an average age of 29 years and an average follow-up time of 31 months. The VAS and Harris scores are improved from the preoperative 4.5±0.92 to 1.6±1.2 and from 56.95±10.6 to 95.95±5.4, respectively. And the Harris score is greater than 90 points in 39 cases, with an excellent rate of 92.8%. The difference between the preoperative and postoperative VAS and Harris scores is statistically significant(P<0.001). However, there is no significant difference between the postoperative and preoperative cartilage degeneration (P=0.083). It is shown that the acetabular labrum arthroscopic repair with suture anchor is effective and has a critical therapeutic value for the acetabular labrum injury.
[1] Seldes R M, Tan V, Hunt J, et al. Anatomy, histologic features, and vascularity of the adult acetabular labrum[J]. Clinical Orthopaedics and Related Research, 2001(382):232-240.
[2] Aydingoz U, Ozturk M H. MR imaging of the acetabular labrum:A comparative study of both hips in 180 asymptomatic volunteers[J]. European Radiology, 2001, 11(4):567-574.
[3] Tan V, Seldes R M, Katz M A, et al. Contribution of acetabular labrum to articulating surface area and femoral head coverage in adult hip joints:An anatomic study in cadavera[J]. American Journal of Orthopedics (Belle Mead, N.J.), 2001, 30(11):809-812.
[4] Crawford M J, Dy C J, Alexander J W, et al. The 2007 Frank Stinchfield Award. The biomechanics of the hip labrum and the stability of the hip[J]. Clinical Orthopaedics and Related Research, 2007(465):16-22.
[5] Myers C A, Register B C, Lertwanich P, et al. Role of the acetabular labrum and the iliofemoral ligament in hip stability:An in vitro biplane fluoroscopy study[J]. The American Journal of Sports Medicine, 2011, 39(Suppl):85-91.
[6] Dwyer M K, Jones H L, Hogan M G, et al. The acetabular labrum regulates fluid circulation of the hip joint during functional activities[J]. The American Journal of Sports Medicine, 2014, 42(4):812-819.
[7] Ferguson S J, Bryant J T, Ganz R, et al. The acetabular labrum seal:A poroelastic finite element model[J]. Clinical Biomechanics (Bristol, Avon), 2000, 15(6):463-468.
[8] Okpala V B, Tennent D J, Johnson A E, et al. Sexual dimorphic features associated with femoroacetabular impingement[J]. U.S. Army Medical Department Journal, 2018(2-18):65-73.
[9] Kamath A F, Componovo R, Baldwin K, et al. Hip arthroscopy for labral tears:Review of clinical outcomes with 4.8-year mean follow-up[J]. The American Journal of Sports Medicine, 2009(37):1721-1727.
[10] Lee J W, Hwang D S, Kang C, et al. Arthroscopic repair of acetabular labral tears associated with femoroacetabular impingement:7-10 years of long-term follow-up results[J]. Orthopaedic Surgery, 2019, 11(1):28-35.
[11] Lodhia P, Gui C, Chandrasekaran S, et al. The economic impact of acetabular labral tears:A cost-effectiveness analysis comparing hip arthroscopic surgery and structured rehabilitation alone in patients without osteoarthritis[J]. The American Journal of Sports Medicine, 2016, 44(7):1771-1780.
[12] Chandrasekaran S, Darwish N, Chaharbakhshi E O, et al. Minimum 2-year outcomes of hip arthroscopic surgery in patients with acetabular overcoverage and profunda acetabulae compared with matched controls with normal acetabular coverage[J]. The American Journal of Sports Medicine, 2017, 45(11):2483-2492.
[13] Risberg M A, Ageberg E, Nilstad A, et al. Arthroscopic surgical procedures versus sham surgery for patients with femoroacetabular impingement and/or labral tears:Study protocol for a randomized controlled trial (HIPARTI) and a prospective cohort study (HARP)[J]. Journal of Orthopaedic & Sports Physical therapy, 2018, 48(4):325-335.
[14] Bsat S, Frei H, Beaule P E, et al. The acetabular labrum:A review of its function[J]. The Bone & Joint Journal, 2016, 98(6):730-735.
[15] Menge T J, Briggs K K, Dornan G J, et al. Survivorship and outcomes 10 years following hip arthroscopy for femoroacetabular impingement:Labral debridement compared with labral repair[J]. Journal of Bone and Joint Surgery-american Volume, 2017, 99(12):997-1004.
[16] Fry R, Domb B. Labral base refixation in the hip:Rationale and technique for an anatomic approach to labral repair[J]. Arthroscopy, 2010, 26(9):81-89.
[17] Hernandez J D, Mcgrath B E. Safe angle for suture anchor insertion during acetabular labral repair[J]. Arthroscopy:The Journal of Arthroscopic & Related Surgery, 2008, 24(12):1390-1394.
[18] Jackson T J, Hammarstedt J E, Vemula S P, et al. Acetabular labral base repair versus circumferential suture repair:A matched-paired comparison of clinical outcomes[J]. Arthroscopy:The Journal of Arthroscopic & Related Surgery, 2015, 31(9):1716-1721.
[19] Shenoy K, Dai A Z, Mahure S A, et al. Arthroscopic repair of hip labrum with suture anchors[J]. Arthroscopy Techniques, 2017, 6(6):2143-2149.
[20] Cvetanovich G L, Weber A E, Kuhns B D, et al. Hip arthroscopic surgery for femoroacetabular impingement with capsular management:Factors associated with achieving clinically significant outcomes[J]. The American Journal of Sports Medicine, 2018, 46(2):288-296.
