대퇴 비구 충돌과 동반된 비구순 파열의 관절경적 비구순 봉합술 - 초기 2-5년 추시 결과 -
Arthroscopic Labral Repair Associated with Femoroacetabular Impingement - Short Term 2-5 Years Follow-up Results -
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목적: 대퇴 비구 충돌 및 비구순 파열로 진단받고 관절경적 비구순 봉합술을 시행한 환자들의 단기 추시 후 결과를 보고하고자 한다. 대상 및 방법: 2008년부터 2010년까지 대퇴 비구 충돌 및 비구순 파열로 진단받고 관절경적 비구순 봉합술을 시행한 45명을 대상으로 하였다. 임상 결과는 modified Harris hip score (MHHS), 통증 점수(VAS), hip outcomes score (HOS) 및 환자 만족도를 이용하였다. 결과: 남자 22명, 여자 23명이었고, 평균 나이는 33.0세(16-54세), 평균 추시 기간은 26.7개월(24-56개월)이었다. 임상적 결과로 VAS는 수술 전 평균 6.4점에서 수술 후 평균 2.5점, MHHS는 수술 전 평균 59.5점에서 수술 후 평균 85.4점으로 호전되었고, HOS의 일상 생활척도와 운동 척도가 각각 수술 전 평균 58.3%, 51.2%, 수술 후 평균 83.0%, 79.8%이었다. 재수술을 시행한 경우는 5예(12.1%)로 비구순 부위의 활액막 증식에 의한 유착이 3예, 봉합 나사못이 빠진 경우가 1예, 이소성 골화가 1예 관찰되었다. 결론: 관절경적 비구순 봉합술은 대퇴 비구 충돌과 동반된 비구순 파열의 치료로 효과적인 방법으로 생각된다.
Abstract
Purpose: The purpose of this study is to report on the short term follow-up of patients who underwent arthroscopic acetabular labral repair for femoroacetabular impingement and acetabular labral tear.. Materials and Methods: A total of 45 consecutive patients who underwent arthroscopic acetabular labral repair after diagnosis of femoroacetabular impingement and acetabular labral tear from January 2008 to December 2010 were included in this study. Modified Harris hip score (MHHS), VAS, Hip outcomes score (HOS), and patient satisfaction were used for evaluation of the clinical results. Results: Patients included 22 males and 23 females, and the mean age of the patients was 33.0(range, 16-54) years old, and the mean follow up period was 26.7(range, 24-56) months. Of the clinical results, mean VAS score was 6.4 and 2.5 points before and after surgery, respectively, and mean MHHS score improved from 59.5 points before surgery to 85.4 points after surgery. Activities of daily living and sports-related activities of HOS were 58.3% and 51.2%, respectively, before surgery, and 83.0% and 79.8% after surgery. Revision arthroscopic surgery was performed on five cases(12.1%); labro-synovial adhesion, three cases, pull-out of suture anchor, one case, heterotropic ossification, one case. Conclusion: Arthroscopic acetabular labral repair is considered an effective treatment for femoroacetabular impingement and accompanying acetabular labral tear.
참고문헌 (26)
- Takechi H, "Intra-articular pressure of the hip joint outside and inside the limbus", Nihon Seikeigeka Gakkai Zasshi, 56, pp.529~536 (1982)
- Kim YT, "The nerve endings of the acetabular labrum", Clin Orthop Relat Res, (320), pp.176~181 (1995)
- Altenberg AR, "Acetabular labral tears: a cause of hip pain and degenerative arthritis", South Med J, 70, pp.174~175 (1977)
- Czerny C, "Lesions of the acetabular labrum: accuracy of MR imaging and MR arthrography in detection and staging", Radiology, 200, pp.225~230 (1996)
- McCarthy JC, "The Otto E. Aufranc Award: The role of labral lesions to development of early degenerative hip disease.", Clin Orthop Relat Res, (393), pp.25~37 (2001)
- Ferguson SJ, "The acetabular labrum seal: a poroelastic finite element model", Clin Biomech(Bristol, Avon), 15, pp.463~468 (2000)
- Ferguson SJ, "The influence of the acetabular labrum on hip joint cartilage consolidation: a poroelastic finite element model", J Biomech, 33, pp.953~960 (2000)
- Ferguson SJ, "An in vitro investigation of the acetabular labral seal in hip joint mechanics", J Biomech, 36, pp.171~178 (2003)
- Petersen W, "Structure and vascularization of the acetabular labrum with regard to the pathogenesis and healing of labral lesions", Arch Orthop Trauma Surg, 123, pp.283~288 (2003)
- Tan V, "Contribution of acetabular labrum to articulating surface area and femoral head coverage in adult hip joints: an anatomic study in cadavera", Am J Orthop(Belle Mead NJ), 30, pp.809~812 (2001)
- Larson CM, "Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement", Arthroscopy, 25, pp.369~376 (2009)
- Espinosa N, "Treatment of femoro-acetabular impingement: preliminary results of labral refixation", J Bone Joint Surg Am, 88, pp.925~935 (2006)
- Philippon MJ, "Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up", J Bone Joint Surg Br, 91, pp.16~23 (2009)
- Suenaga E, "Relationship between the maximum flexion-internal rotation test and the torn acetabular labrum of a dysplastic hip", J Orthop Sci, 7, pp.26~32 (2002)
- Klaue K, "The acetabular rim syndrome. A clinical presentation of dysplasia of the hip", J Bone Joint Surg Br, 73, pp.423~429 (1991)
- Lage LA, "The acetabular labral tear: an arthroscopic classification", Arthroscopy, 12, pp.269~272 (1996)
- Hwang DS, "The usefulness of hip arthroscopy", J Korean Orthop Asso, 37, pp.587~593 (2002)
- Kelly BT, "Arthroscopic labral repair in the hip: surgical technique and review of the literature", Arthroscopy, 21, pp.1496~1504 (2005)
- 황득수, "연령과 연관된 성인 고관절 비구순의 형태병리학적 연구", 대한정형외과학회지, 38(4), pp.5~360 (2003), 대한정형외과학회
- Kelly BT, "Vascularity of the hip labrum: a cadaveric investigation", Arthroscopy, 21, pp.3~11 (2005)
- Seldes RM, "Anatomy, histologic features, and vascularity of the adult acetabular labrum", Clin Orthop Relat Res, (382), pp.232~240 (2001)
- Philippon MJ, "Arthroscopic repair of the acetabular labrum: a histologic assessment of healing in an ovine model", Arthroscopy, 23, pp.376~380 (2007)
- Song Y, "Articular cartilage friction increases in hip joints after the removal of acetabular labrum", J Biomech, 45, pp.524~530 (2012)
- Streich NA, "Prognostic value of chondral defects on the outcome after arthroscopic treatment of acetabular labral tears", Knee Surg Sports Traumatol Arthrosc, 17, pp.1257~1263 (2009)
- Harris JD, "Complications and reoperations during and after hip arthroscopy: a systematic review of 92 studies and more than 6,000 patients", Arthroscopy, 29, pp.589~595 (2013)
- Papavasiliou AV, "Complications of arthroscopic surgery of the hip", Bone Joint Res, 1, pp.131~144 (2012)