Abstract:Objective To assess the effect of suturing the joint capsule in arthroscopic surgery for femoralacetabular impingement(FAI).Methods A total of 62 patients diagnosed with FAI and treated with hip arthroscopy in Guangdong Provincial Hospital of Chinese Medicine from June 2019 to December 2020 were retrospectively analyzed.All patients underwent hip arthroscopy,labrum repair and femur plasty.According to whether the joint capsule was sutured in the operation or not,patients were divided into sutured group (n=32) and unsutured group (n=30).There were 15 males and 17 females,with an average age of (36.3±8.9) in sutured group.There were 14 males and 16 females,with an average age of (37.8±6.2) in unsutured group.Shoelace method was applied to suture joint capsule in the sutured group,while the joint capsule was left unsutured in the other group.All patients were assessed by the modified Harris hip score (mHHS),hip outcome score sports specific subscale (HOS-SSS),hip outcome score-activities of daily living (HOS-ADL).MRI was performed six months after the operation to evaluate the capsular condition.Results The operations in both groups were successfully completed.The operation time of sutured group was significantly longer than that of unsutured group (P<0.05),but there was no significant difference in day of hospitalization between the two groups (P>0.05).No serious complications occurred.All patients were followed up for 9~12 months,with a mean follow-up of (10.2±5.3)months.Preoperative HOS-ADL score,HOS-SSS score,mHHS score had no significant difference between the two groups (P>0.05).HOS-ADL score,HOS-SSS score,mHHS score were significantly increased in both groups at 6 months (P<0.001).HOS-ADL score,HOS-SSS score,mHHS score of the sutured group were higher than those of the unsutured group at the 6-month follow-up (P<0.05).Conclusion Suturing the joint capsule with shoelace method in arthroscopic hip surgery can improve the clinical outcome of FAI arthroscopic hip surgery,without increasing risk of complications.
[1]杨伟铭,曹学伟.髋关节镜下盂唇修补术治疗髋臼盂唇损伤的疗效评价[J].中国中医骨伤科杂志,2020,28(4):15-19.
[2]杨伟铭,曹学伟,赵彩琼.关节镜治疗合并棘下撞击的髋臼盂唇损伤患者临床疗效评价[J].实用骨科杂志,2021,27(12):1076-1079.
[3]Kizaki K,Hatakeyama A,Utsunomiya H,et al.Arthroscopic double shoelace capsular plication technique for the treatment of borderline hip dysplasia associated with capsular laxity[J].Arthrosc Tech,2019,8(8):e923-e927.
[4]Martin RL,Kelly BT,Philippon MJ.Evidence of validity for the hip outcome score[J].Arthroscopy,2006,22(12):1304-1311.
[5]Bedi A,Kelly BT,Khanduja V.Arthroscopic hip preservation surgery:current concepts and perspective[J].Bone Joint J,2013,95-B(1):10-19.
[6]陈哲峰,王瑞,刘锋.关节囊修补对股骨髋臼撞击综合征关节镜手术疗效的影响[J].中华骨科杂志,2019,39(11):691-698.
[7]Myers CA,Register BC,Lertwanich P,et al.Role of the acetabular labrum and the iliofemoral ligament in hip stability:An in vitro biplane fluoroscopy study[J].Am J Sports Med,2011(39 Suppl):S85-91.
[8]Telleria J,Lindsey DP,Giori NJ,et al.An anatomic arthroscopic description of the hip capsular ligaments for the hip arthroscopist[J].Arthroscopy,2011,27(5):628-636.
[9]罗智文,陈疾忤.髋关节不稳的诊断与治疗研究进展[J].中国运动医学杂志,2020,39(9):732-741.
[10]Khair MM,Grzybowski JS,Kuhns BD,et al.The effect of capsulotomy and capsular repair on hip distraction:A cadaveric investigation[J].Arthroscopy,2017,33(3):559-565.
[11]Wuerz TH,Song SH,Grzybowski JS,et al.Capsulotomy size affects hip joint kinematic stability[J].J Arthrosc Relat Surg,2016,32(8):1571-1580.
[12]Yeung M,Memon M,Simunovic N,et al.Gross instability after hip arthroscopy:An analysis of case reports evaluating surgical and patient factors[J].J Arthrosc Relat Surg,2016,32(6):1196-1204.
[13]Frank RM,Lee S,Bush-Joseph CA,et al.Improved outcomes after hip arthroscopic surgery in patients undergoing T-capsulotomy with complete repair versus partial repair for femoroacetabular impingement:a comparative matched-pair analysis[J].Am J Sports Med,2014,42(11):2634-2642.
[14]Duplantier NL,McCulloch PC,Nho SJ,et al.Hip dislocation or subluxation after hip arthroscopy:A systematic review[J].Arthroscopy,2016,32(7):1428-1434.
[15]潘廷明,王雪松,张晋,等.髋关节镜下手术治疗股骨髋臼撞击征行关节囊缝合与否临床效果的比较[J].骨科临床与研究杂志,2019,4(4):200204;218.
[16]Walters BL,Cooper JH,Rodriguez JA.New findings in hip capsular anatomy:dimensions of capsular thickness and pericapsular contributions[J].Arthroscopy,2014,30(10):1235-1245.