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Outcomes following surgical management of femoroacetabular impingement: a systematic review and meta-analysis of different surgical techniques.
Bone & Joint Research ( IF 4.7 ) Pub Date : 2021-9-8 , DOI: 10.1302/2046-3758.109.bjr-2020-0443.r1
Daniel Addai 1, 2 , Jacqueline Zarkos 1 , Matthew Pettit 3 , Karadi Hari Sunil Kumar 4 , Vikas Khanduja 5
Affiliation  

Outcomes following different types of surgical intervention for femoroacetabular impingement (FAI) are well reported individually but comparative data are deficient. The purpose of this study was to conduct a systematic review (SR) and meta-analysis to analyze the outcomes following surgical management of FAI by hip arthroscopy (HA), anterior mini open approach (AMO), and surgical hip dislocation (SHD). This SR was registered with PROSPERO. An electronic database search of PubMed, Medline, and EMBASE for English and German language articles over the last 20 years was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We specifically analyzed and compared changes in patient-reported outcome measures (PROMs), α-angle, rate of complications, rate of revision, and conversion to total hip arthroplasty (THA). A total of 48 articles were included for final analysis with a total of 4,384 hips in 4,094 patients. All subgroups showed a significant correction in mean α angle postoperatively with a mean change of 28.8° (95% confidence interval (CI) 21 to 36.5; p < 0.01) after AMO, 21.1° (95% CI 15.1 to 27; p < 0.01) after SHD, and 20.5° (95% CI 16.1 to 24.8; p < 0.01) after HA. The AMO group showed a significantly higher increase in PROMs (3.7; 95% CI 3.2 to 4.2; p < 0.01) versus arthroscopy (2.5; 95% CI 2.3 to 2.8; p < 0.01) and SHD (2.4; 95% CI 1.5 to 3.3; p < 0.01). However, the rate of complications following AMO was significantly higher than HA and SHD. All three surgical approaches offered significant improvements in PROMs and radiological correction of cam deformities. All three groups showed similar rates of revision procedures but SHD had the highest rate of conversion to a THA. Revision rates were similar for all three revision procedures.

中文翻译:

股骨髋臼撞击症手术治疗后的结果:不同手术技术的系统评价和荟萃分析。

对股骨髋臼撞击症 (FAI) 进行不同类型手术干预后的结果已单独报告,但缺乏比较数据。本研究的目的是进行系统评价 (SR) 和荟萃分析,以分析通过髋关节镜 (HA)、前路微型开放入路 (AMO) 和手术髋关节脱位 (SHD) 对 FAI 进行手术治疗后的结果。该 SR 已在 PROSPERO 注册。根据系统评价和元分析的首选报告项目 (PRISMA) 指南,对过去 20 年中英语和德语文章的 PubMed、Medline 和 EMBASE 进行了电子数据库搜索。我们专门分析和比较了患者报告结果测量 (PROM)、α 角、并发症发生率、翻修率、并转换为全髋关节置换术 (THA)。共纳入 48 篇文章进行最终分析,4,094 名患者共 4,384 髋。所有亚组术后平均 α 角均显着矫正,AMO 后平均变化为 28.8°(95% 置信区间 (CI) 21 至 36.5;p < 0.01),21.1°(95% CI 15.1 至 27;p < 0.01) ) 后 SHD,和 20.5°(95% CI 16.1 至 24.8;p < 0.01)后 HA。AMO 组的 PROM(3.7;95% CI 3.2 至 4.2;p < 0.01)与关节镜检查(2.5;95% CI 2.3 至 2.8;p < 0.01)和 SHD(2.4;95% CI 1.5 至3.3;p < 0.01)。然而,AMO 术后并发症发生率明显高于 HA 和 SHD。所有三种手术方法都在 PROM 和凸轮畸形的放射学矫正方面提供了显着改进。所有三组都显示出相似的翻修率,但 SHD 转换为 THA 的比率最高。所有三种翻修程序的翻修率相似。
更新日期:2021-09-08
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