Junk in the joint: A trend for arthroscopic debridement to improve outcomes following closed reduction of traumatic hip dislocation

摘要

Purpose: To determine whether arthroscopic debridement following closed reduction of traumatic hip dislocation is associated with less persistent pain and functional impairment than closed reduction alone. Methods: Retrospective comparative study, consisting of telephone interview, 2-14 years postinjury. Subjects were IS patients aged 18 years or older at time of injury who received closed reduction of traumatic hip dislocation with arthroscopy (seven patients) or without arthroscopy (eight patients) at a level I trauma center between 2000 and 2012. The exposure was arthroscopic removal of intra-articular loose bodies following closed reduction. The primary outcome was the American Academy of Orthopaedic Surgeons'6 Hip & Knee Outcomes Questionnaire. Results: Among the patients who received arthroscopy, the mean Hip & Knee Core Scale standardized score (0-100) was 98 (SD 2), as compared to 86 (SD 29) among patients who did not. These scores showed a statistical trend toward less pain and improved function in the arthroscopy group (p = 0.069). No patients in the arthroscopy group had scores below the average among healthy people, as compared to three of eight (38%) in the control group. Conclusions: Patients who underwent arthroscopic debridement in addition to closed reduction had nonsignificant improvements in pain, stiffness, swelling, and functional impairment as compared to those who received closed reduction alone. Though not significant, these results warrant further study to determine whether arthroscopy is indicated for all patients suffering traumatic hip dislocation. Level of Evidence: IV