| BackgroundHip is the body’s largest ball and socket joint and the good relationship of acetabular and femoral bones is necessary for maintaining the stability and flexible activities of hip joint. In the past,pain of Hip joint is mainly considered avascular necrosis of the femoral head, DDH and osteoarthritis disease.Pain of hip joint without obvious imaging signs is unable to make a clear diagnosis, and the empirical effect after symptomatic treatment is generally poor, affects the life quality of the patients; In recent years, clinical department of orthopedics physicians get more and more attention to femoral acetabular impingement syndrome (FAI); FAI is a cause of chronic pain of the hip joint and decrease the activity of hip joint. In the year of 2003, formally proposed by Ganz et al, FAI is defined as:the femoral and/or acetabular of hip joint has non developmental anatomical abnormalities, causing abnormal collision between proximal femor and Acetabulum edge in the end-stage of the hip movement. FAI often occurs in young and middle-aged people with large activities and athletes and so on;according to statistics, the incidence of FAI is up to 20-25%,and is now considered to be the early pathological changes of osteoarthritis of the hip joint. Along with the more research by domestic and foreign scholars on the FAI and the development of arthroscopic technology, so that the diagnosis and treatment of FAI has a more complete and accurate standards.FAI has three types). Cam type、Pincer type and Mixed type. Its pathogenesis is not yet well understanding, it is generally thought that is the proximal part of the femoral neck and (or) acetabular morphology abnormalities, leading to the abnormal contaction between the Femoral head or femoral neck and acetabular fossa, the Repeated impact lead to glenoid labrum apart, and secondary cartilage injury. Clinical manifestations without obvious symptoms, mainly for early chronic pain in the groin or intermittent dull pain in front of hip, father developed into the lower lumbar region, greater trochanter and buttock, aggravated by sedentary or post-activities, appear hip "interlocking", "suffer from limb weakness and other symptoms. Physical examination found hip impact experiment (frontal impact and rear crash) positive. Femoroacetabular impingement syndrome mainly was diagnosed on the basis of the X-ray, CT and MRI examination, Treatment includes conservative therapy and surgical therapy.Purpose1. By imaging examination results, we mark the hip center edge angle (LCE), acetabular index (AI), femoral head protrusion index (Fei), alpha angle and eccentricity distance (offset) parameters,to understand the classification of Femoroacetabular impingement syndrome, and on the basis of classification to guide clinical treatment.2. Through the clinical follow-ups of two groups of patients (conservative treatment group with arthroscopy), compare the effection between conservative therapy group and arthroscopic therapy group,aim to guide clinical treatment.MethodOn the basis of literature review, set femoroacetabular impingement syndrome diagnostic criteria:aangle> 50 degrees, LCE> 40 degrees, offset less than normal value (11.6+0.7 mm).AI<0, FEI<10%;no matter which one conforms to the standard can be diagnosed as FAI. X-ray must be done for clinically suspected patients, and make diagnosis and classification according to the statistical data.24 patients voluntarily participate in with clinical trials, and according to the different treatment options, we divide into two groups for follow-up (13 cases of conservative treatment, 11 cases underwent arthroscopic surgery), compared two groups of follow-up results. Major indices:VAS pain score, Harris score, impact experiments.ResultAfter the measurement and analysis on imaging datas,we get a total of 46 cases of patients with FAI, including 11 cases of patients with bilateral disease, a total of 57 bips.According to the results of the parameters,11 cases of type cam,7 cases of pincer type, mixed type 39 cases.Parameter values are as follows:alpha angle 35.18 -63.15°, the average (54.50°±3.60°); offset value 2.7-8.4mm,average (6.8±0.7) mm;LCE 33.30°～55.10°, average (41.40°±2.9°);AI value-5.60-3.40, average (-1.70+0.8); FEI 4.4%-10.5%, the average (7.2±1.0)%.2.Two groups of patients there is no significant difference in age; Before treatment, the two groups have no significant difference on VAS pain score and Harris hip score; 9 cases impingement syndrome is positive in conservative group,8 in operation group. In conservative treatment group, the symptoms were not relieved. 9 cases of patients with impingement syndrome remained positive.In operation group of patients with symptoms were relieved, painless or mild pain, only 1 case patients with residual impingement positive.ConclusionSurgical treatment can completely remove the abnormal structure of the hip joint, remove the cause of the disease, the treatment effect is satisfactory. The surgical treatment compared with conservative treatment can obtain Satisfactory therapeutic effect... |
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