Background:

Increasing evidence supports surgical intervention for hip abductor tears; however, the influence of fatty infiltration (FI) on outcomes after repair remains uncertain and has been addressed only in small case series.

Purpose:

To clarify the relationship between FI and surgical outcomes for hip abductor tears.

Study Design:

Meta-analysis; Level of evidence, 4.

Methods:

A systematic review and meta-analysis was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. FI severity was assessed by Goutallier-Fuchs (G-F) grade. The relationship between FI and improvement in Harris Hip Score (HHS)/modified Harris Hip Score (mHHS) and visual analog scale (VAS) score for pain was examined with mixed-effects metaregression. Outcomes with open and endoscopic techniques were also compared.

Results:

A total of 4 studies (206 repairs in 201 patients) were eligible. High-grade FI was associated with significantly less improvement in HHS/mHHS than both no FI (6.761 less; 95% CI, 3.983-11.570; P = .002) and low-grade FI (7.776 less; 95% CI, 2.460-11.062; P < .001) but did not significantly influence VAS score (P > .05). Controlling for FI severity, we found no significant difference in HHS/mHHS improvement between open versus endoscopic repair (P > .05 at each level), but open repair resulted in significantly greater improvement in VAS score for every G-F grade (all P < .005).

Conclusion:

Surgical intervention for symptomatic hip abductor tendon tears improved outcomes as reflected by change in HHS/mHHS; however, the presence of high-grade FI resulted in less improvement. FI severity did not influence VAS scores for pain. Although no differences were found between open and endoscopic repairs in terms of FI-adjusted improvement in HHS/mHHS, open repairs resulted in significantly greater pain relief at each FI level.

中文翻译：

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脂肪浸润对髋外展肌修复结果的影响：系统评价和荟萃分析

背景：

越来越多的证据支持对髋外展肌撕裂进行手术干预；然而，脂肪浸润 (FI) 对修复后结果的影响仍不确定，仅在小型病例系列中得到解决。

目的：

阐明 FI 与髋外展肌撕裂手术结果之间的关系。

学习规划：

荟萃分析；证据水平，4。

方法：

根据 PRISMA（系统评价和 Meta 分析的首选报告项目）指南进行系统评价和荟萃分析。FI 严重程度通过 Goutallier-Fuchs (GF) 等级评估。FI 与 Harris 髋关节评分 (HHS)/改良的 Harris 髋关节评分 (mHHS) 和视觉模拟评分 (VAS) 疼痛评分改善之间的关系采用混合效应元回归进行检查。还比较了开放和内窥镜技术的结果。

结果：

共有 4 项研究（201 名患者的 206 次修复）符合条件。高等级 FI 与 HHS/mHHS 的改善显着低于无 FI（6.761 少；95% CI，3.983-11.570；P = .002）和低等级 FI（7.776 少；95% CI，2.460- 11.062；P < .001）但对 VAS 评分没有显着影响（P > .05）。控制 FI 严重程度，我们发现开放式修复与内窥镜修复之间的 HHS/mHHS 改善没有显着差异（每个级别P > .05），但开放式修复导致每个 GF 级别的 VAS 评分显着改善（所有P < . 005)。

结论：

有症状的髋外展肌腱撕裂的手术干预改善了结果，这反映在 HHS/mHHS 的变化上；然而，高级 FI 的存在导致改善较少。FI 严重程度不影响疼痛的 VAS 评分。尽管在 HHS/mHHS 的 FI 调整改善方面，开放式修复和内窥镜修复之间没有发现差异，但开放式修复在每个 FI 水平上都能显着改善疼痛缓解。