Background:Arthroscopic treatment is recommended for hip synovial chondromatosis. However, evidence regarding long-term clinical outcomes is limited.Purpose:To evaluate long-term patient-reported outcomes (PROs) and survival, and to determine the potential effect of residual loose bodies, as evaluated by immediate postoperative computed tomography (CT), on clinical outcomes.Study Design:Case series; Level of evidence, 4.Methods:A consecutive cohort of patients undergoing arthroscopic treatment and diagnosed with synovial chondromatosis between March 2010 and May 2015 were included in the study. Preoperative radiography, CT, and magnetic resonance imaging were performed. Preoperative, midterm (minimum of 4 years), and long-term (minimum of 8 years) PROs were collected for visual analog scale for pain, modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and 12-item international Hip Outcome Tool (iHOT-12). The percentages achieving minimal clinically important difference (MCID) were calculated. PROs and survival were compared between patients with and without residual loose bodies evident on immediate postoperative CT scan.Results:A total of 28 patients (20% of patients were lost to follow-up) were included in the study with a mean follow-up period of 104.9 months (range, 96-139 months). PROs including visual analog scale for pain (preoperative, 3.8 ± 1.2; midterm, 0.9 ± 1.7; long-term, 0.8 ± 1.4), mHHS (preoperative, 66.4 ± 14.4; midterm, 92.8 ± 12.3; long-term, 93.5 ± 10.5), NAHS (preoperative, 45.2 ± 16.2; midterm, 81.8 ± 15.3; long-term, 83.1 ± 12.9), and iHOT-12 (preoperative, 48.4 ± 15.6; midterm, 69.3 ± 11.7; long-term, 72.7 ± 11.4) were improved at both midterm and long-term follow-up (all with P < .001). In total, 27 (96.4%), 28 (100%), and 26 (92.9%) patients achieved MCID for mHHS, NAHS and iHOT-12, respectively, at the long-term follow-up. No significant difference was found in any of the PROs and the rate of achieving MCID between midterm and long-term follow-up (all with P > .05). One patient (3.6%) underwent revision surgery. Among the 23 patients who had loose bodies on preoperative CT or radiographs, 14 patients (60.9%) with residual loose bodies evident on immediate postoperative CT demonstrated lower NAHS ( P = .045) and iHOT-12 ( P = .037) scores but a comparable survival ( P > .05) at long-term follow-up compared with those who did not have loose bodies.Conclusion:Arthroscopic treatment for hip synovial chondromatosis achieved satisfactory long-term clinical outcomes with strong survival. Most patients maintained or improved their overall functional status between midterm and long-term follow-up. Furthermore, patients with residual loose bodies had less favorable clinical outcomes, although the survival rate was comparable.

中文翻译：

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关节镜治疗髋关节滑膜软骨瘤后临床结果的纵向评估以及残留游离体的影响：至少 4 年和 8 年随访


背景：建议采用关节镜治疗髋关节滑膜软骨瘤病。然而，有关长期临床结果的证据有限。 目的：评估患者报告的长期结果 (PRO) 和生存率，并通过术后立即计算机断层扫描 (CT) 评估确定残留游离体的潜在影响研究设计：病例系列；证据级别，4。方法：该研究纳入了2010年3月至2015年5月期间接受关节镜治疗并诊断为滑膜软骨瘤病的连续队列患者。术前进行X线摄影、CT和磁共振成像。收集术前、中期（至少 4 年）和长期（至少 8 年）PRO，用于疼痛视觉模拟量表、改良 Harris 髋关节评分 (mHHS)、非关节炎髋关节评分 (NAHS) 和 12- item International 髋关节结果工具 (iHOT-12)。计算实现最小临床重要差异（MCID）的百分比。比较术后立即 CT 扫描显示残留游离体和不残留游离体的患者的 PRO 和生存率。结果：共有 28 名患者（其中 20% 的患者失访）纳入研究，平均随访时间期限为 104.9 个月（范围为 96-139 个月）。 PRO 包括疼痛视觉模拟量表（术前，3.8 ± 1.2；中期，0.9 ± 1.7；长期，0.8 ± 1.4）、mHHS（术前，66.4 ± 14.4；中期，92.8 ± 12.3；长期，93.5 ± 10.5） ）、NAHS（术前，45.2 ± 16.2；中期，81.8 ± 15.3；长期，83.1 ± 12.9）和 iHOT-12（术前，48.4 ± 15.6；中期，69.3 ± 11.7；长期，72.7 ± 11.4）中期和长期随访均得到改善（均 P < .001）。总共有 27 个（96.4%）、28 个（100%）和 26 个（92.9%）患者在长期随访中分别达到 mHHS、NAHS 和 iHOT-12 的 MCID。中期和长期随访之间的任何 PRO 和达到 MCID 的比率均未发现显着差异（均 P > .05）。一名患者（3.6%）接受了翻修手术。在 23 名术前 CT 或 X 光片上有游离体的患者中，14 名患者 (60.9%) 术后即刻 CT 上有明显残留游离体，其 NAHS ( P = .045) 和 iHOT-12 ( P = .037) 评分较低，但与无游离体的患者相比，长期随访生存率相当（P > .05）。结论：关节镜治疗髋关节滑膜软骨瘤病取得了满意的长期临床结果，生存率高。大多数患者在中期和长期随访期间维持或改善了总体功能状态。此外，尽管存活率相当，但残留游离体的患者临床结果较差。