Background: Pain in patients with orthopedic problems is an important aspect of surgical evaluation. However, the effect on the quality of life depends not only on the degree of pain but also on its type. Hip arthrosc...Background: Pain in patients with orthopedic problems is an important aspect of surgical evaluation. However, the effect on the quality of life depends not only on the degree of pain but also on its type. Hip arthroscopy has been performed for hip joint symptoms caused by femoroacetabular impingement (FAI) and hip labrum tears. However, the degree and type of pain after hip arthroscopy remains unknown. Objective: This study aimed to clarify the degree and type of pain during 6 months after hip arthroscopy. Methods: Non-athlete patients aged 20 - 65 years who underwent hip arthroscopy between December 2018 and October 2019 participated in a questionnaire survey before hospitalization and at 1, 3, and 6 months after surgery. The questionnaire comprised the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) for quality of life, International Physical Activity Questionnaire (IPAQ) for activities, and the Short-Form McGill Pain Questionnaire (SF-MPQ-2) for pain. Results: The analysis included 10 patients (men: 4, women: 6, mean age: 38 ± 8.6 years, FAI: 6 cases, hip labrum tears: 4 cases). The average time from symptom onset to surgery was 26.9 ± 19.0 months. The analysis from before surgery to 6 months after surgery showed improvement over time in all scale scores (JHEQ, IPAQ, and SF-MPQ-2). The degree of pain was significantly improved based on the JHEQ visual analog scale evaluation (P = 0.019) 3 months after surgery. Significant improvement in intermittent pain (P = 0.011) based on SF-MPQ-2 was noted 3 months after surgery;however, no significant improvement in continuous pain was noted. Conclusions: Patients who underwent hip arthroscopy showed significant improvements in the degree of pain and type of intermittent pain from before surgery to 3 months after surgery, however, no change was observed in continuous pain.展开更多
Objective: Hip arthroscopy technique application of diagnosis and treatment of suspected intra-articular infection cases after total hip arthroplasty. Methods: After femoral prosthesis side debridement processing thor...Objective: Hip arthroscopy technique application of diagnosis and treatment of suspected intra-articular infection cases after total hip arthroplasty. Methods: After femoral prosthesis side debridement processing thoroughly, we do skin preparation and draping again for exploring intra-articular using hip arthroscopy technique. Results: Though hip arthroscopy we can see a lot of scar hyperplasia and no obvious signs of infection. Conclusion: Minimally invasive techniques of hip arthroscopy can be applied to the detection of intra-articular infection after total hip arthroplasty.展开更多
Background： Avascular necrosis of femoral head （AVNFH） typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still con...Background： Avascular necrosis of femoral head （AVNFH） typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. Methods： This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients （98 hips） with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips （Group A） or drilling decompression alone in 34 cases/55 hips （Group B）. Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. Results： All patients were followed up for an average of 57.6 months （range： 17-108 months）. Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris＇ scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 （t = -7.21, P = 0.001） than Group B with mean Harris＇ scores improved from 69.46 ± 9.71 to 75.79± 4.13 （t = -9.47, P = 0.037） （significantly different： t = -2.54, P = 0.017）. The total surgery effective rate was also significantly different between Groups A and B （86.0% vs. 74.5%; Z2 = 3.69, P = 0.02）. Conclusion： For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.展开更多
Objective To evaluate the efficacy of arthroscopic surgery in inflammatory hip arthritis.Methods A retrospective clinical study was conducted inspecting 40 hips in 36 patients of inflammatory arthritis.There were 17 c...Objective To evaluate the efficacy of arthroscopic surgery in inflammatory hip arthritis.Methods A retrospective clinical study was conducted inspecting 40 hips in 36 patients of inflammatory arthritis.There were 17 cases of ankylosing spondylitis,11 cases of rheumatoid arthritis,and 8 cases of psoriatic arthritis.The joints were irrigated and the inflamed tissues were debrided with anthroscopy.The patients were followed up with Harris hip score,Oxford hip score,Visual Analog Scale(VAS),and magnetic resonance imaging(MRI).Statistical analysis was performed using Student t test.Results All of the 36 cases were followed up for 46-103 months,averaging 67.2±8.4 months.Harris and Oxford scores increased from 66.9±12.1 and 69.4±16.4 before operation to 78.4±19.3 and 80.2±18.8 after operation,respectively(P<0.05).VAS score decreased from pre-operative 8.5±2.5 to post-operative 7.2±2.5(P<0.05).All the patients showed improved joint range of motion.MRI revealed alleviation of hip synovitis.The results were classified as excellent in 8 patients,good in 17 patients,fair in 8 patient,and poor in 3 according to Harris hip score.Twenty-seven patients were satisfied with the operative outcomes as they regained normal daily activities.Conclusions Arthroscopy-assisted joint debridement and synovium resection is an effective procedure for hip lesion in inflammatory arthritis.The inflammatory lesion might be thereby controlled and the symptoms be relieved.展开更多
<i><span style="font-family:Verdana;">Background</span></i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span styl...<i><span style="font-family:Verdana;">Background</span></i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">:</span></i></span></span><span><span><span style="font-family:;" "=""> <span style="font-family:Verdana;">Synovial cysts of the hip are commonly found in patients with intra- or extraarticular pathologies of the joint. Symptoms are mostly unspecific. To date there are no guidelines for a gold standard of treatment. Aim of this article is to show up how lesions of the ligamentum teres (LT) might possibly lead to a specific formation of synovial cysts of the hip joint and how this can be treated arthroscopically. </span><i><span style="font-family:Verdana;">Methods</span></i></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">:</span></i></span></span><span><span><span style="font-family:;" "=""> <span style="font-family:Verdana;">This case series included 3 patients with ganglia of the hip. All patients had impingement symptoms, combined with untypical location of pain. All patients qualified for joint preserving surgery and underwent hip arthroscopy with pre- and postoperative MRI imaging. The mean follow-up time was 22 months. </span><i><span style="font-family:Verdana;">Results</span></i></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">:</span></i></span></span><span><span><span style="font-family:;" "=""> <span style="font-family:Verdana;">MRI imaging showed extensive ganglia, presumably originating from the pelvic root of LT, extending to the obturator lodge. In 2 of 3 cases MRI showed lesions of the LT. Hip arthroscopy revealed damage of the LT in all cases, caused by chronic instability of the joint. The postoperative MRI showed a complete regression of the ganglia in all patients after offset correction. After follow-up, 2 of 3 patients were mostly symptom free. One patient was still suffering from a chronic weakness of the gluteus medius muscle. </span><i><span style="font-family:Verdana;">Conclusion</span></i></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">:</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Whenever unspecific radiating pain of surrounding areas of the hip is encountered and cannot be explained by common pathologies of the hip, possible compression of nerves by ganglion cysts should be excluded. This should be done by MRI arthrography. A partial rupture of the LT can occur during FAI with consecutive formation of ganglia in the obturator canal, compressing the obturator nerve. Primarily the articular pathology needs to be repaired. In our cases, this was feasible by hip arthroscopy, as a minimally invasive and safe technique.</span></span></span>展开更多
文摘Background: Pain in patients with orthopedic problems is an important aspect of surgical evaluation. However, the effect on the quality of life depends not only on the degree of pain but also on its type. Hip arthroscopy has been performed for hip joint symptoms caused by femoroacetabular impingement (FAI) and hip labrum tears. However, the degree and type of pain after hip arthroscopy remains unknown. Objective: This study aimed to clarify the degree and type of pain during 6 months after hip arthroscopy. Methods: Non-athlete patients aged 20 - 65 years who underwent hip arthroscopy between December 2018 and October 2019 participated in a questionnaire survey before hospitalization and at 1, 3, and 6 months after surgery. The questionnaire comprised the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) for quality of life, International Physical Activity Questionnaire (IPAQ) for activities, and the Short-Form McGill Pain Questionnaire (SF-MPQ-2) for pain. Results: The analysis included 10 patients (men: 4, women: 6, mean age: 38 ± 8.6 years, FAI: 6 cases, hip labrum tears: 4 cases). The average time from symptom onset to surgery was 26.9 ± 19.0 months. The analysis from before surgery to 6 months after surgery showed improvement over time in all scale scores (JHEQ, IPAQ, and SF-MPQ-2). The degree of pain was significantly improved based on the JHEQ visual analog scale evaluation (P = 0.019) 3 months after surgery. Significant improvement in intermittent pain (P = 0.011) based on SF-MPQ-2 was noted 3 months after surgery;however, no significant improvement in continuous pain was noted. Conclusions: Patients who underwent hip arthroscopy showed significant improvements in the degree of pain and type of intermittent pain from before surgery to 3 months after surgery, however, no change was observed in continuous pain.
文摘Objective: Hip arthroscopy technique application of diagnosis and treatment of suspected intra-articular infection cases after total hip arthroplasty. Methods: After femoral prosthesis side debridement processing thoroughly, we do skin preparation and draping again for exploring intra-articular using hip arthroscopy technique. Results: Though hip arthroscopy we can see a lot of scar hyperplasia and no obvious signs of infection. Conclusion: Minimally invasive techniques of hip arthroscopy can be applied to the detection of intra-articular infection after total hip arthroplasty.
文摘Background： Avascular necrosis of femoral head （AVNFH） typically presents in the young adults and progresses quickly without proper treatments. However, the optimum treatments for early stage of AVNFH are still controversial. This study was conducted to evaluate the therapeutic effects of multiple small-diameter drilling decompression combined with hip arthroscopy for early AVNFH compared to drilling alone. Methods： This is a nonrandomized retrospective case series study. Between April 2006 and November 2010, 60 patients （98 hips） with early stage AVNFH participated in this study. The patients underwent multiple small-diameter drilling decompression combined with hip arthroscopy in 26 cases/43 hips （Group A） or drilling decompression alone in 34 cases/55 hips （Group B）. Patients were followed up at 6, 12, and 24 weeks, and every 6 months thereafter. Radiographs were taken at every follow-up, Harris scores were recorded at the last follow-up, the paired t-test was used to compare the postoperative Harris scores. Surgery effective rate of the two groups was compared using the Chi-square test. Results： All patients were followed up for an average of 57.6 months （range： 17-108 months）. Pain relief and improvement of hip function were assessed in all patients at 6 months after the surgery. At the last follow-up, Group A had better outcome with mean Harris＇ scores improved from 68.23 ± 11.37 to 82.07 ± 2.92 （t = -7.21, P = 0.001） than Group B with mean Harris＇ scores improved from 69.46 ± 9.71 to 75.79± 4.13 （t = -9.47, P = 0.037） （significantly different： t = -2.54, P = 0.017）. The total surgery effective rate was also significantly different between Groups A and B （86.0% vs. 74.5%; Z2 = 3.69, P = 0.02）. Conclusion： For early stage of AVNFH, multiple small-diameter drilling decompression combined with hip arthroscopy is more effective than drilling decompression alone.
文摘Objective To evaluate the efficacy of arthroscopic surgery in inflammatory hip arthritis.Methods A retrospective clinical study was conducted inspecting 40 hips in 36 patients of inflammatory arthritis.There were 17 cases of ankylosing spondylitis,11 cases of rheumatoid arthritis,and 8 cases of psoriatic arthritis.The joints were irrigated and the inflamed tissues were debrided with anthroscopy.The patients were followed up with Harris hip score,Oxford hip score,Visual Analog Scale(VAS),and magnetic resonance imaging(MRI).Statistical analysis was performed using Student t test.Results All of the 36 cases were followed up for 46-103 months,averaging 67.2±8.4 months.Harris and Oxford scores increased from 66.9±12.1 and 69.4±16.4 before operation to 78.4±19.3 and 80.2±18.8 after operation,respectively(P<0.05).VAS score decreased from pre-operative 8.5±2.5 to post-operative 7.2±2.5(P<0.05).All the patients showed improved joint range of motion.MRI revealed alleviation of hip synovitis.The results were classified as excellent in 8 patients,good in 17 patients,fair in 8 patient,and poor in 3 according to Harris hip score.Twenty-seven patients were satisfied with the operative outcomes as they regained normal daily activities.Conclusions Arthroscopy-assisted joint debridement and synovium resection is an effective procedure for hip lesion in inflammatory arthritis.The inflammatory lesion might be thereby controlled and the symptoms be relieved.
文摘<i><span style="font-family:Verdana;">Background</span></i><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">:</span></i></span></span><span><span><span style="font-family:;" "=""> <span style="font-family:Verdana;">Synovial cysts of the hip are commonly found in patients with intra- or extraarticular pathologies of the joint. Symptoms are mostly unspecific. To date there are no guidelines for a gold standard of treatment. Aim of this article is to show up how lesions of the ligamentum teres (LT) might possibly lead to a specific formation of synovial cysts of the hip joint and how this can be treated arthroscopically. </span><i><span style="font-family:Verdana;">Methods</span></i></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">:</span></i></span></span><span><span><span style="font-family:;" "=""> <span style="font-family:Verdana;">This case series included 3 patients with ganglia of the hip. All patients had impingement symptoms, combined with untypical location of pain. All patients qualified for joint preserving surgery and underwent hip arthroscopy with pre- and postoperative MRI imaging. The mean follow-up time was 22 months. </span><i><span style="font-family:Verdana;">Results</span></i></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">:</span></i></span></span><span><span><span style="font-family:;" "=""> <span style="font-family:Verdana;">MRI imaging showed extensive ganglia, presumably originating from the pelvic root of LT, extending to the obturator lodge. In 2 of 3 cases MRI showed lesions of the LT. Hip arthroscopy revealed damage of the LT in all cases, caused by chronic instability of the joint. The postoperative MRI showed a complete regression of the ganglia in all patients after offset correction. After follow-up, 2 of 3 patients were mostly symptom free. One patient was still suffering from a chronic weakness of the gluteus medius muscle. </span><i><span style="font-family:Verdana;">Conclusion</span></i></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><i><span style="font-family:Verdana;">:</span></i></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Whenever unspecific radiating pain of surrounding areas of the hip is encountered and cannot be explained by common pathologies of the hip, possible compression of nerves by ganglion cysts should be excluded. This should be done by MRI arthrography. A partial rupture of the LT can occur during FAI with consecutive formation of ganglia in the obturator canal, compressing the obturator nerve. Primarily the articular pathology needs to be repaired. In our cases, this was feasible by hip arthroscopy, as a minimally invasive and safe technique.</span></span></span>
