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.
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.
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).
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.
Despite normalization of coverage we found a high postoperative rate of clinical signs of FAI after PAO in males.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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。
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）。
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。
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。
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。
