2026年4月 保髋稳定性补充文献荟萃

摘要：BACKGROUND: Long-term outcomes of femoroacetabular impingement (FAI) surgery, particularly survivorship, are critical to guide treatment decision-making and patient counseling, yet only a limited number of studies have reported mid- to long-term survivorship. The purpose of this study was to report survivorship rates at a mean 10-year follow-up in a large, multicenter FAI surgery cohort and to identify clinical predictors of survivorship. METHODS: A prospective, multicenter cohort study assessed patients treated for FAI with hip arthroscopy or surgical dislocation from 2008 to 2012. At a minimum of 8 years, 362 hips (80.1%) had follow-up that permitted assessment of total hip arthroplasty (THA)-free survivorship. A Cox proportional-hazards model was developed to identify risk factors for T...

摘要：BACKGROUND: The purpose of this study is to compare acetabular remodeling rates in age and severity matched, idiopathic DDH patients undergoing closed reduction (CR) versus open reduction alone (OR) versus open reduction supplemented by ligamentum teres reconstruction (LTR) utilizing a suture button device. METHODS: Prospectively obtained data of patients who underwent open reduction with LTR were compared with historic cohorts of children 2.5 years or younger who underwent CR or OR. Acetabular index (AI) was measured on radiographs taken prior to reduction and on serial postoperative follow-ups. Monthly and yearly rates of AI change were calculated. Subgroup analysis of the prospective LTR cohort was performed to characterize how the rate of acetabular remodeling changes with increasing t...

摘要：Capsule-sparing techniques in hip arthroscopy including periportal and puncture capsulotomy aim to minimize disruption of the iliofemoral ligament while maintaining adequate visualization and treatment of intra-articular pathology. By limiting iatrogenic injury to the capsule, these approaches may offer advantages such as reduced scar tissue or adhesions, avoidance of need for capsular closure, and potentially faster recovery. Concerns remain regarding technical difficulty of these techniques and the ability to adequately visualize and maneuver in all cases. Current evidence suggests that capsule-sparing techniques can achieve comparable patient-reported outcomes to traditional interportal or T-capsulotomy techniques with capsule closure. Capsular management should therefore be individuali...

摘要：PURPOSE: To investigate the influence of peak contralateral pelvic drop and ipsilateral femoral adduction during running on traditional radiographic parameters of femoral head coverage. METHODS: This cross-sectional retrospective study included 19 patients (38 hips), 9 males and 10 females, with a mean age of 40 ± 10 years, all presenting with symptomatic unilateral femoroacetabular impingement. Participants underwent a three-dimensional running analysis and anteroposterior pelvic radiographs. Using specialised software, the femur and pelvis were rotated in the coronal plane based on the peak angles of contralateral pelvic drop and femoral adduction obtained from the biokinetic running analysis. After prior validation, traditional femoral head coverage parameters were assessed on both stan...

摘要：CASE: A 21-year-old woman with a surgical history of 2 prior right hip surgeries presented with ongoing right hip pain. Radiographic findings demonstrated a labral tear, osteoarthritic changes, and cam over-resection. Arthroscopic iliotibial band autograft labral reconstruction and bony remplissage of the femoral defect using a greater trochanter autograft were performed. CONCLUSION: Arthroscopic bony hip remplissage is a viable treatment option for young patients who present after failed hip arthroscopy with cam over-resection.

摘要：BACKGROUND: Instability remains one of the most common complications after total hip arthroplasty (THA) and is a notable cause of patient morbidity, pain, and dissatisfaction. Despite advances in implant technology and surgical techniques, the national incidence of instability after THA remains poorly defined. As THA continues to rise, our study aimed to characterize the contemporary volume and economic impact of revision THA (rTHA) for instability in the United States (U.S.). METHODS: There were two national databases that were queried to identify inpatient and outpatient rTHA cases for instability between 2012 and 2022. Exclusion criteria included patients who presented with a periprosthetic joint infection. The national volume of rTHA for instability was calculated, and projected volume...

摘要：BACKGROUND: Data on midterm outcomes in patients with borderline hip dysplasia (BHD) based on sex differences after hip arthroscopy are scarce. PURPOSE: To report sex-based differences in patient-reported outcome measures (PROMs), clinical benefit, and survivorship in patients with BHD who underwent hip arthroscopy at a minimum 5-year follow-up. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data were retrospectively reviewed for all patients with BHD who underwent primary hip arthroscopy with a lateral center-edge angle (LCEA) between 18° and 25° from 2008 to 2018. The exclusion criteria were as follows: LCEA <18º or >25º, previous ipsilateral hip surgery or conditions, and Tönnis grade >1. The modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), and visual analog...

摘要：BACKGROUND: Acetabular labral tears are a common cause of hip pain. While larger tear size has been linked to worse outcomes after arthroscopic treatment, the influence of labral tear location remains incompletely understood. PURPOSE: To investigate how labral tear location affects functional outcomes, conversion to total hip arthroplasty (THA), and patient satisfaction after arthroscopy. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients who underwent primary hip arthroscopy were retrospectively sent online surveys at a minimum of 8 years after their surgery. Tear location was classified into superior, anterosuperior, and posterosuperior based on intraoperative findings. Outcomes included patient-reported outcome measures, conversion to THA, Patient Acceptable Symptom Sta...

摘要：BACKGROUND: Variables predictive of achieving clinically meaningful outcomes in high-level adult athletes after primary hip arthroscopy at midterm follow-up remain incompletely defined. PURPOSE: To identify variables predictive of achieving the patient acceptable symptom state (PASS) for the Hip Outcome Score-Sports-Specific Subscale (HOS-SSS) at a minimum 5-year follow-up after primary hip arthroscopy in high-level adult athletes. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: Data were prospectively collected and retrospectively reviewed for adult (≥18 years old) athletes who underwent primary hip arthroscopy for femoroacetabular impingement syndrome between February 2010 and August 2016. Inclusion criteria consisted of participation in high school, collegiate, or profe...

摘要：PURPOSE: To analyze minimum 5-year outcomes after arthroscopic treatment of femoroacetabular impingement syndrome (FAIS) utilizing the periportal capsulotomy technique for joint access without capsular closure. METHODS: A retrospective review of a prospectively collected database of patients undergoing primary hip arthroscopy for FAIS without clinical signs of hypermobility was performed to analyze patients who underwent hip arthroscopy utilizing the periportal capsulotomy technique without capsule closure with minimum 5-year follow-up. Periportal capsulotomy was utilized for joint access, and arthroscopic labral treatment and osteochondroplasty were completed as indicated without capsular closure. Patient demographics, surgical details, and complications were recorded. Pre- and postoperat...

摘要：BACKGROUND: Psychiatric comorbidity-most commonly depression and anxiety-is frequently reported among patients undergoing hip arthroscopy and may influence postoperative trajectories, but existing analyses vary in scope and methods, limiting clinical interpretation. PURPOSE: To determine whether recorded psychiatric diagnoses are associated with worse surgical, patient-reported, and health care utilization outcomes after hip arthroscopy. STUDY DESIGN: Systematic review and meta-analysis; Level of evidence, 3. METHODS: The authors conducted a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-compliant search (International Prospective Register of Systematic Reviews [PROSPERO] CRD420251101816) of the MEDLINE, Embase, Web of Science, and PsycINFO databases to identif...

摘要：BACKGROUND: High-level athletes who undergo hip arthroscopy for femoroacetabular impingement syndrome (FAIS) return to sport (RTS) at a high rate. However, the influence of athlete-specific factors, including sport, sex, and clinical and surgical findings, on the time to RTS remains unclear. PURPOSE: To determine if the time to RTS clearance is influenced by sport and sex in collegiate athletes following hip arthroscopy, as well as determine if the time to RTS is impacted by clinical and surgical factors. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: In total, 62 Division I collegiate athletes (26 female; 89 hips) who underwent hip arthroscopy for FAIS between January 2017 and July 2024 were included in this analysis of routinely collected health and performance data. Demograp...

摘要：BACKGROUND: Femoroacetabular impingement syndrome (FAIS) is a major cause of chronic hip pain and early osteoarthritis. Surgical correction, traditionally via open surgical dislocation and increasingly via hip arthroscopy, aims to restore hip function by correcting bony morphology. While both techniques address cam and pincer lesions, the long-term implications of the surgical approach and specific impingement morphology on five-year structural outcomes, including hip instability, osteoarthritis (OA) progression, and conversion to total hip arthroplasty (THA), remain poorly defined. METHODS: We conducted a retrospective cohort study using the TriNetX US Collaborative Network, analyzing de-identified electronic medical records from 2,725 patients (2,321 arthroscopic, 404 open) who underwent...

摘要：BACKGROUND: Paralabral cysts are one of the signs of labral injury; however, it remains unclear whether they affect the mid-term clinical outcomes after hip arthroscopy. PURPOSE: To compare the midterm patient-reported outcomes (PROs) of hip arthroscopy for labral tear with or without paralabral cysts, with a minimum follow-up of 5 years. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A retrospective matched cohort study was conducted on patients who underwent unilateral hip arthroscopy for labral tear between November 2015 and September 2019. Exclusion criteria comprised nonlabral tear indications, prior hip surgery, incomplete data, or loss to follow-up. Patients with paralabral cysts confirmed by magnetic resonance imaging (MRI) were designated as the cyst group (n = 35), wh...

摘要：INTRODUCTION: Hip instability is an important complication of spinal muscular atrophy (SMA), which leads to various functional impairments, including mobility challenges and difficulties with daily care. The primary objective of this study is to determine the prevalence and severity of hip instability in a cohort of SMA patients managed at a tertiary care center. The prevalence of scoliosis and its association with hip instability in children with SMA were also assessed. METHODS: This is a retrospective cross-sectional study including children with a genetic diagnosis of SMA and available hip x-rays, conducted between 2018 and 2023. Patients were grouped based on SMA type and motor status (non-sitters, sitters, or walkers). Relevant parameters were collected including hip subluxation/dislo...

摘要：BACKGROUND/AIM: In professional soccer, comprehensive musculoskeletal assessments are performed prior to player transfers to evaluate both the current condition and future risk of injury. MRI plays a crucial role in this process, effectively revealing musculoskeletal findings even in the absence of symptoms. This study presents common musculoskeletal MRI findings in professional soccer players undergoing pre-signing assessments and their associations with age, playing position and footedness. METHODS: In this retrospective study, musculoskeletal 3 Tesla MRI scans obtained during pre-signing medical assessments of professional soccer players from August 2019 to March 2025 were included. Clinical data were extracted from medical records and supplemented with publicly available player informa...