Background:In the setting of femoroacetabular impingement (FAI), decompression osteoplasties reconcile deleterious loading patterns caused by cam and pincer lesions. However, native variations of spinopelvic sagittal alignment may continue to perpetuate detrimental effects on the labrum, chondrolabral junction, and articular cartilage after hip arthroscopy.Purpose:To evaluate the effect of pelvic incidence (PI) on postoperative outcomes after hip arthroscopy for acetabular labral tears in the setting of FAI.Study Design:Cohort study; Level of evidence, 3.Methods:A retrospective query of prospectively collected data identified patients ≥18 years of age who underwent primary hip arthroscopy for FAI and acetabular labral tears between February 2014 and January 2022, with 3-, 6-, 12-, and 24-month follow-ups. Measurements for PI, pelvic tilt (PT), sacral slope (SS), and acetabular version were obtained via advanced diagnostic imaging. Patients were stratified into low-PI (<45°), moderate-PI (45°≤ PI ≤ 60°), and high-PI (>60°) cohorts. Patient-reported outcome measures (PROMs), clinically meaningful outcomes (ie, minimal clinically important difference, Patient Acceptable Symptom State, substantial clinical benefit, and maximal outcome improvement), visual analog scale (VAS) pain scores, and patient satisfaction were compared across cohorts.Results:A total of 74 patients met eligibility criteria and were stratified into low-PI (n = 28), moderate-PI (n = 31), and high-PI (n = 15) cohorts. Correspondingly, patients with high PI displayed significantly greater values for PT ( P = .001), SS ( P < .001), acetabular version ( P < .001), and acetabular inclination ( P = .049). By the 12- and 24-month follow-ups, the high-PI cohort was found to have significantly inferior PROMs, VAS pain scores, rates of clinically meaningful outcome achievement, and satisfaction relative to patients with moderate and/or low PI. No significant differences were found between cohorts regarding rates of revision arthroscopy, subsequent spine surgery, or conversion to total hip arthroplasty.Conclusion:After hip arthroscopy, patients with a high PI (>60°) exhibited inferior PROMs, rates of achieving clinically meaningful thresholds, and satisfaction at 12 and 24 months relative to patients with low or moderate PI. Conversely, the outcomes of patients with low PI (<45°) were found to match the trajectory of those with a neutral spinopelvic alignment (45°≤ PI ≤ 60°). These findings highlight the importance of analyzing spinopelvic parameters preoperatively to prognosticate outcomes before hip arthroscopy for acetabular labral tears and FAI.

中文翻译：

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骨盆倾角对股骨髋臼撞击和髋臼盂唇撕裂髋关节镜术后结果的影响

背景：在股骨髋臼撞击（FAI）的情况下，减压骨成形术可以协调由凸轮和钳状病变引起的有害负荷模式。然而，髋关节镜检查后，脊柱骨盆矢状排列的固有变化可能会继续对盂唇、软骨盂唇交界处和关节软骨产生有害影响。 目的：评估髋臼盂唇撕裂髋关节镜检查后骨盆倾角 (PI) 对术后结果的影响在FAI的背景下，研究设计：队列研究；证据水平，3.方法：对前瞻性收集的数据进行回顾性查询，确定了 2014 年 2 月至 2022 年 1 月期间因 FAI 和髋臼盂唇撕裂而接受初次髋关节镜检查的年龄≥18 岁的患者，其中 3-、6-、12-、以及24个月的随访。通过先进的诊断成像获得 PI、骨盆倾斜 (PT)、骶骨倾斜 (SS) 和髋臼版本的测量值。患者被分为低 PI (<45°)、中 PI (45°≤ PI ≤ 60°) 和高 PI (>60°) 队列。比较患者报告的结果测量（PROM）、临床有意义的结果（即最小的临床重要差异、患者可接受的症状状态、实质性临床获益和最大结果改善）、视觉模拟量表（VAS）疼痛评分和患者满意度结果：共有 74 名患者符合资格标准，并被分为低 PI (n = 28)、中 PI (n = 31) 和高 PI (n = 15) 队列。相应地，高 PI 患者的 PT ( P = .001)、SS ( P < .001)、髋臼版本 ( P < .001) 和髋臼倾斜度 ( P = .049) 的值显着更高。通过 12 个月和 24 个月的随访，发现高 PI 队列的 PROM、VAS 疼痛评分、临床有意义的结果实现率以及满意度相对于中度和/或低 PI 患者显着较差。在翻修关节镜检查、随后的脊柱手术或转换为全髋关节置换术的比率方面，队列之间没有发现显着差异。结论：髋关节镜检查后，高 PI（> 60°）的患者表现出较差的 PROM，达到有临床意义的阈值的比率以及 12 个月和 24 个月时相对于低或中 PI 患者的满意度。相反，低 PI（<45°）患者的结果与中性脊柱骨盆排列（45°≤ PI ≤ 60°）患者的轨迹相匹配。这些发现强调了术前分析脊柱骨盆参数对于在髋关节镜检查前预测髋臼盂唇撕裂和 FAI 的结果的重要性。