Background:Hip arthroscopy is rapidly advancing, with positive published outcomes at short- and midterm follow-up; however, available long-term data remain limited.Purpose:To evaluate outcomes of primary hip arthroscopy at a minimum 10-year follow-up at 2 academic centers by describing patient-reported outcomes and determining reoperation and total hip arthroplasty (THA) rates.Study Design:Case series; Level of evidence, 4.Methods:Patients with primary hip arthroscopy performed between January 1988 and April 2013 at 2 academic centers were evaluated for postoperative patient-reported outcomes—including the visual analog scale, Tegner Activity Scale score, Hip Outcome Score Activities of Daily Living and Sport Specific subscales, modified Harris Hip Score, Nonarthritic Hip Score, 12-item International Hip Outcome Tool, surgery satisfaction, and reoperations.Results:A total of 294 patients undergoing primary hip arthroscopy (age, 40 ± 14 years; 66% women; body mass index, 27 ± 6) were followed for 12 ± 3 years (range, 10-24 years) postoperatively. Labral debridement and repair were performed in 41% and 59% of patients, respectively. Of all patients who underwent interportal capsulotomy, 2% were extended to a T-capsulotomy, and 11% underwent capsular repair. At final follow-up, patients reported a mean visual analog scale at rest of 2 ± 2 and with use of 3 ± 3, a 12-item International Hip Outcome Tool of 68 ± 27, a Nonarthritic Hip Score of 81 ± 18, a modified Harris Hip Score of 79 ± 17, and a Hip Outcome Score Activities of Daily Living of 82 ± 19 and Sport Specific subscale of 74 ± 25. The mean surgical satisfaction was 8.4 ± 2.4 on a 10-point scale, with 10 representing the highest level of satisfaction. In total, 96 hips (33%) underwent reoperation—including 65 hips (22%) converting to THA. THA risk factors included older age, higher body mass index, lower lateral center-edge angle, larger alpha angle, higher preoperative Tönnis grade, as well as labral debridement and capsular nonrepair ( P≤ .039). Patients undergoing combined labral and capsular repair demonstrated a THA conversion rate of 3% compared with 31% for patients undergoing combined labral debridement and capsular nonrepair ( P = .006). Labral repair trended toward increased 10-year THA-free survival (84% vs 77%; P = .085), while capsular repair demonstrated significantly increased 10-year THA-free survival (97% vs 79%; P = .033).Conclusion:At a minimum 10-year follow-up, patients undergoing primary hip arthroscopy demonstrated high satisfaction and acceptable outcome scores. In total, 33% of patients underwent reoperation—including 22% who underwent THA. Conversion to THA was associated with patient factors including older age, higher Tönnis grade, and potentially modifiable surgical factors such as labral debridement and capsular nonrepair.

中文翻译：

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初次髋关节镜检查的长期结果：至少 10 年随访的多中心分析，关注盂唇和关节囊管理

背景：髋关节镜检查正在迅速发展，在短期和中期随访中已发表积极的结果；然而，可用的长期数据仍然有限。 目的：通过描述患者报告的结果并确定再次手术和全髋关节置换术 (THA) 率，评估 2 个学术中心至少 10 年随访的初次髋关节镜检查的结果。研究设计：案例系列；证据水平，4.方法：对 1988 年 1 月至 2013 年 4 月期间在 2 个学术中心进行初次髋关节镜检查的患者进行术后患者报告的结果评估，包括视觉模拟量表、Tegner 活动量表评分、每日髋关节结果活动评分生活和运动特定子量表、改良的 Harris 髋关节评分、非关节炎髋关节评分、12 项国际髋关节结果工具、手术满意度和再次手术。 结果：总共 294 名接受初次髋关节镜检查的患者（年龄，40 ± 14 岁；66%）女性；体重指数，27 ± 6）术后随访 12 ± 3 年（范围，10-24 年）。分别有 41% 和 59% 的患者进行了盂唇清创术和修复术。在所有接受门间囊切开术的患者中，2% 的患者进行了 T 型囊切开术，11% 的患者接受了囊膜修复术。在最终随访时，患者报告静息时的平均视觉模拟评分为 2 ± 2，使用 3 ± 3 时，12 项国际髋关节结果工具为 68 ± 27，非关节炎髋关节评分为 81 ± 18，改良的 Harris 髋关节评分为 79 ± 17，髋关节结果评分日常生活活动为 82 ± 19，运动特定子量表为 74 ± 25。平均手术满意度为 8.4 ± 2.4（10 分制），其中 10 代表最高程度的满意度。总共有 96 个髋关节 (33%) 接受了再次手术，其中 65 个髋关节 (22%) 转为全髋关节置换术。 THA 危险因素包括年龄较大、体重指数较高、外侧中心边缘角较低、α 角较大、术前 Tönnis 分级较高以及盂唇清创和囊膜未修复 (P≤ .039)。接受盂唇和囊膜联合修复的患者的 THA 转换率为 3%，而接受盂唇清创和囊膜不修复联合治疗的患者的 THA 转换率为 31% (P = .006)。盂唇修复有增加 10 年无 THA 生存率的趋势（84% vs 77%；P = .085），而囊膜修复则显着增加 10 年无 THA 生存率（97% vs 79%；P = .033）结论：在至少 10 年的随访中，接受初次髋关节镜检查的患者表现出很高的满意度和可接受的结果评分。总共有 33% 的患者接受了再次手术，其中 22% 的患者接受了全髋关节置换术。转为THA与患者因素相关，包括年龄较大、Tönnis分级较高以及可能可改变的手术因素，例如盂唇清创和囊膜不修复。