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男性的伯尔尼髋臼周围截骨术:伯尔尼髋臼周围截骨术后发生股骨髋臼撞击症(FAI)的风险是否增加?

Bernese periacetabular osteotomy in males: is there an increased risk of femoroacetabular impingement (FAI) after Bernese periacetabular osteotomy?

机构信息

Department of Orthopaedic Surgery, Universitätsklinik Inselspital, University of Berne, Berne, Switzerland.

出版信息

Clin Orthop Relat Res. 2011 Feb;469(2):447-53. doi: 10.1007/s11999-010-1544-9.


DOI:10.1007/s11999-010-1544-9
PMID:20848246
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3018207/
Abstract

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.

摘要

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。

相似文献

[1]
Bernese periacetabular osteotomy in males: is there an increased risk of femoroacetabular impingement (FAI) after Bernese periacetabular osteotomy?

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[6]
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[7]
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[8]
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引用本文的文献

[1]
Anteroinferior iliac spine osteoplasty at the time of periacetabular osteotomy helps preserve preoperative range of motion.

J Hip Preserv Surg. 2025-1-30

[2]
Impact of Periacetabular Osteotomy on Cartilage Enhancement in Crowe Group I Hip Dysplasia: A Short-Term Analysis.

Med Sci Monit. 2025-5-23

[3]
Short-term outcomes of periacetabular osteotomy versus periacetabular osteotomy with concomitant femoral osteochondroplasty: a propensity matched analysis.

J Hip Preserv Surg. 2024-12-18

[4]
Computer-Assisted Hip Arthroscopic Surgery for Secondary Femoroacetabular Impingement After Rotational Acetabular Osteotomy Using Capsular Takedown Techniques.

Arthrosc Tech. 2024-8-20

[5]
Predictive Factors for Intraoperative Determination for the Need of Femoral Osteochondroplasty After Periacetabular Osteotomy for Acetabular Dysplasia.

Iowa Orthop J. 2024

[6]
Arthroscopy Confers Favorable Clinical Outcomes in Asian Patients with Borderline Developmental Dysplasia of the Hip.

Orthop Surg. 2023-9

[7]
Pain, function and quality of life are impaired in adults undergoing periacetabular osteotomy (PAO) for hip dysplasia: a systematic review and meta-analysis.

Hip Int. 2024-1

[8]
Physical impairments in Adults with Developmental Dysplasia of the Hip (DDH) undergoing Periacetabular osteotomy (PAO): A Systematic Review and Meta-Analysis.

Int J Sports Phys Ther. 2022-10-1

[9]
Highly Cited Articles in Periacetabular Osteotomy Research.

Hip Pelvis. 2022-6

[10]
Effect of modeling femoral version and head-neck offset correction on computed contact mechanics in dysplastic hips treated with periacetabular osteotomy.

J Biomech. 2022-8

本文引用的文献

[1]
Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome.

J Bone Joint Surg Am. 2009-9

[2]
Periacetabular osteotomy for acetabular dysplasia in patients older than 40 years: a preliminary study.

Clin Orthop Relat Res. 2009-9

[3]
Periacetabular osteotomy: a systematic literature review.

Clin Orthop Relat Res. 2009-8

[4]
Morphological variations of residual hip dysplasia in the adult.

Hip Int. 2007

[5]
Incidence and characteristics of femoral deformities in the dysplastic hip.

Clin Orthop Relat Res. 2009-1

[6]
Periacetabular osteotomy and total hip arthroplasty in patients older than 40 years.

J Arthroplasty. 2008-10

[7]
Mean 20-year followup of Bernese periacetabular osteotomy.

Clin Orthop Relat Res. 2008-7

[8]
Radiographic analysis of femoroacetabular impingement with Hip2Norm-reliable and validated.

J Orthop Res. 2008-9

[9]
Delayed gadolinium-enhanced magnetic resonance imaging of cartilage to predict early failure of Bernese periacetabular osteotomy for hip dysplasia.

J Bone Joint Surg Am. 2006-7

[10]
The Bernese periacetabular osteotomy: clinical, radiographic and mechanical 7-15-year follow-up of 26 hips.

Acta Orthop. 2005-12

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