Extra-Articular Hip Impingement: A Systematic Review Examining Operative Treatment of Psoas, Subspine, Ischiofemoral, and Greater Trochanteric/Pelvic Impingement

被引:72
作者
de Sa, Darren [1 ]
Alradwan, Hussain [1 ,4 ]
Cargnelli, Stephanie [2 ]
Thawer, Zoyah [2 ]
Simunovic, Nicole [3 ]
Cadet, Edwin [6 ]
Bonin, Nicolas [5 ]
Larson, Christopher [7 ]
Ayeni, Olufemi R. [1 ]
机构
[1] McMaster Univ, Med Ctr, Dept Surg, Div Orthopaed Surg, Hamilton, ON L8N 3Z5, Canada
[2] McMaster Univ, Michael G DeGroote Sch Med, Hamilton, ON L8N 3Z5, Canada
[3] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
[4] Minist Higher Educ, Riyadh, Saudi Arabia
[5] Lyon Orthoclin, Lyon, France
[6] Raleigh Orthopaed Clin, Raleigh, NC USA
[7] Twin Cities Orthoped, Minnesota Orthoped Sports Med Inst, Edina, MN USA
关键词
INFERIOR ILIAC SPINE; AVULSION; PATIENT; SERIES;
D O I
10.1016/j.arthro.2014.02.042
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Purpose: Extra-articular hip impingement can be the result of psoas impingement (PI), subspine impingement (SSI), ischiofemoral impingement (IFI), and greater trochanteric/pelvic impingement (GTPI). Symptoms may be due to bony abutment or soft-tissue irritation, and often, it is a challenge to differentiate among symptoms preoperatively. Currently, the clinical picture and diagnostic criteria are still being refined for these conditions. This systematic review was conducted to examine each condition and elucidate the indications for, treatment options for, and clinical outcomes of surgical management. Methods: We searched online databases (Medline, Embase, and PubMed) for English-language clinical studies published from database inception through December 31, 2013, addressing the surgical treatment of PI, SSI, IFI, and GTPI. For each condition, 2 independent assessors reviewed eligible studies. Descriptive statistics are presented. Results: Overall, 9,521 studies were initially retrieved; ultimately, 14 studies were included examining 333 hips. For PI, arthroscopic surgery resulted in 88% of patients achieving good to excellent results, as well as significant improvements in the Harris Hip Score (P = .008), Hip Outcome Scoree-Activities of Daily Living (P = .02), and Hip Outcome Scoree-Sport (P = .04). For SSI, arthroscopic decompression, with no major complications, resulted in a mean 18.5 degrees improvement in flexion range of motion, as well as improvements in pain (mean visual analog scale score of 5.9 points preoperatively and 1.2 points postoperatively) and the modified Harris Hip Score (mean of 64.97 points preoperatively and 91.3 points postoperatively). For both IFI and GTPI, open procedures anecdotally improved patient symptoms, with no formal objective outcomes data reported. Conclusions: This review suggests that there is some evidence to support that surgical treatment, by arthroscopy for PI and SSI and by open surgery for IFI and GTPI, results in improved patient outcomes.
引用
收藏
页码:1026 / 1041
页数:16
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