Department of Orthopaedic Surgery, Universitätsklinik Inselspital, University of Berne, Berne, Switzerland.
Clin Orthop Relat Res. 2011 Feb;469(2):447-53. doi: 10.1007/s11999-010-1544-9.
BACKGROUND: The Bernese periacetabular osteotomy (PAO) is a popular option for treating symptomatic acetabular dysplasia. We noted symptomatic impingement after PAO in several male patients. QUESTIONS/PURPOSES: We therefore determined (1) the incidence of clinical signs of FAI after PAO in the male population; and (2) whether any factors were associated with the positive impingement signs after PAO in males. PATIENTS AND METHODS: We retrospectively reviewed 38 males who underwent 46 periacetabular osteotomies (PAO) between 2000 and 2007. Clinical and radiographic data were analyzed with the focus on pre- and postoperative incidence of femoroacetabular impingement. Minimum followup was 12 months (average, 43 months; range, 12-90 months). RESULTS: We found a positive impingement sign in 19 of the 46 hips during the preoperative examination compared to 22 (47.8%) hips postoperatively. The ROM (flexion and internal rotation) decreased postoperatively compared to preoperatively. Radiographic parameters of coverage LCE-, ACE- and Tönnis angle improved into the normal range. Twenty hips had postoperative heterotopic ossification to varying degrees, mostly minor. WOMAC scores improved in the function and pain domains postoperatively. CONCLUSIONS: Despite normalization of coverage we found a high postoperative rate of clinical signs of FAI after PAO in males. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
背景:伯尔尼髋臼周围截骨术(PAO)是治疗髋臼发育不良的一种常用方法。我们注意到一些男性患者在接受 PAO 后出现了症状性撞击。
问题/目的:因此,我们确定了(1)男性人群接受 PAO 后出现 FAI 临床症状的发生率;以及(2)男性患者在接受 PAO 后是否存在任何与阳性撞击迹象相关的因素。
患者和方法:我们回顾性分析了 2000 年至 2007 年间接受 46 例髋臼周围截骨术(PAO)的 38 例男性患者的临床和影像学资料。重点分析了术前和术后股骨髋臼撞击症的发生率。最低随访时间为 12 个月(平均随访时间为 43 个月;范围为 12-90 个月)。
结果:与术前相比,在 46 个髋关节中有 19 个髋关节在术前检查中出现阳性撞击征,而术后有 22 个髋关节(47.8%)出现阳性撞击征。术后髋关节活动度(屈伸和内旋)较术前减少。覆盖的影像学参数 LCE-、ACE-和 Tönnis 角改善至正常范围。20 个髋关节有不同程度的术后异位骨化,主要为轻度。WOMAC 评分在术后功能和疼痛方面均有所改善。
结论:尽管覆盖范围正常,但我们发现男性患者在接受 PAO 后仍存在较高的术后股骨髋臼撞击症临床症状发生率。
证据水平:IV 级,治疗性研究。请参阅作者指南以获取完整的证据水平描述。
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