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Arthroscopic Treatment of Femoroacetabular Impingement of the Hip: 5-7 Years Result

대퇴 비구 충돌 환자의 관절경적 치료: 5-7년 추시 결과

  • Kang, Chan (Department of Orthopaedic Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine) ;
  • Hwang, Deuk-Soo (Department of Orthopaedic Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine) ;
  • Jeon, Yoo-Sun (Department of Orthopaedic Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine) ;
  • Han, Sun-Cheol (Department of Orthopaedic Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine) ;
  • Lee, Gi-Soo (Department of Orthopaedic Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine) ;
  • Kang, Dong-Hun (Department of Orthopaedic Surgery, Research Institute for Medical Science, Chungnam National University School of Medicine)
  • 강찬 (충남대학교 의학전문대학원 정형외과학교실.의학연구소) ;
  • 황득수 (충남대학교 의학전문대학원 정형외과학교실.의학연구소) ;
  • 전유선 (충남대학교 의학전문대학원 정형외과학교실.의학연구소) ;
  • 한순철 (충남대학교 의학전문대학원 정형외과학교실.의학연구소) ;
  • 이기수 (충남대학교 의학전문대학원 정형외과학교실.의학연구소) ;
  • 강동훈 (충남대학교 의학전문대학원 정형외과학교실.의학연구소)
  • Received : 2012.04.21
  • Accepted : 2012.07.26
  • Published : 2012.09.30

Abstract

Purpose: To report the mid- and long-term follow up results of patients who underwent arthroscopic treatment after being diagnosed with femoroacetabular impingement. Materials and Methods: 72 consecutive patients diagnosed with femoroacetabular impingement underwent arthroscopic partial labrectomy and femoroplasty(79 cases). In order to evaluate the clinical results, a modified Harris hip score, and VAS and Hip outcome scores were utilized. In addition, the alpha angle and femoral offset were measured radiologically. Results: Based on the clinical results from all consecutive patients, the preoperative mean pain score was 6.0 and 1.7, and 2.1 points on the mid-(2-5 years) and long-term(5-7 years) follow ups, respectively. The mean modified Harris hip score improved from 58.9 points to 81.9 and 79.3 points for the mid-term and long-term follow up groups, respectively. Prior to surgery, the daily activity scale and motor scale results associated with Hip outcome scores were 59.2 and 57.5 points for the mid- and long-term groups, respectively. These scores improved to 84.7 and 84.5, and 81.2 and 79.5 for each group upon the mid- and long-term postoperative follow ups, respectively. Based on the radiological results, the mean alpha angle decreased from $61.2^{\circ}$ preoperatively to $40.9^{\circ}$ after surgery, and the mean femoral offset increased from 4.8 mm to 10.0 mm. Conclusion: The mid- and long-term clinical and radiological follow ups to evaluate the results of arthroscopic treatment of femoroacetabular impingement revealed satisfactory improvement. This finding further demonstrates that arthroscopy is an effective and safe treatment for cases of femoroacetabular impingement.

목적: 대퇴 비구 충돌로 진단받고 관절경적 치료를 시행한 환자들의 중장기 추시 후 결과를 보고하고자 한다. 대상 및 방법: 대퇴 비구 충돌로 진단받고 관절경적 비구순 부분 제거술, 대퇴 성형술 혹은 비구 성형술을 시행한 79예를 대상으로 하였다. 임상 결과는 변형된 해리스 고관절 점수, 통증 점수 및 Hip outcome score를 이용하였고, 방사선학적으로 알파각과 대퇴 오프셋을 측정하였다. 결과: 임상적 결과로 수술전, 중기(2-5년) 및 장기(5-7년)의 통증 점수는 6.0점, 1.7점, 2.1점, 변형된 해리스 고관절 점수는 58.9점, 81.9점, 79.3점으로 나타났고, Hip outcome score는 일상 생활척도가 각각 술 전 59.2점에서 중기 84.7점, 장기 81.2점, 운동 척도는 57.5점, 84.5점, 79.5점으로 호전된 결과를 보였다. 방사선학적으로 알파각은 술 전 $61.2^{\circ}$에서 $40.9^{\circ}$로 감소하였으며, 대퇴 오프셋은 술 전 4.8 mm에서 10.0 mm로 증가하였다. 결론: 대퇴 비구 충돌의 관절경적 치료는 중기와 장기 추시상 방사선적 평가 및 임상적 결과에서 만족할 만한 결과를 보였고, 대퇴 비구 충돌의 증상 호전에 효과적인 방법으로 안전하게 시행할 수 있는 치료 방법으로 사료된다.

Keywords

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