Bogunovic Ljiljana, Hunt Devyani, Prather Heidi, Schoenecker Perry L, Clohisy John C
Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA.
Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA
Am J Sports Med. 2014 Aug;42(8):1791-5. doi: 10.1177/0363546514535906. Epub 2014 Jun 9.
Periacetabular osteotomy is a well-described surgical intervention for symptomatic acetabular deformities in skeletally mature patients. Data regarding return to athletic activity or sport after this procedure are still limited.
To evaluate the ability of patients to return to preoperative levels of activity after periacetabular osteotomy.
Case series; Level of evidence, 4.
This is a retrospective review of active patients treated with periacetabular osteotomy for acetabular deformity correction. Patients were identified as those with preoperative University of California-Los Angeles activity levels ≥7. Patient demographics, operative data, radiographic measures, and clinical outcomes were documented prospectively. The University of California-Los Angeles activity score, Harris Hip Score, Hip Dysfunction and Osteoarthritis Outcome Score, and Western Ontario and McMaster Universities Osteoarthritis Index were used to measure clinical outcomes, and details regarding activity and satisfaction were analyzed.
This study included 36 patients (39 hips; 15 males and 21 females) whose average age was 25 years (range, 15-45 years) and whose average body mass index was 24 ± 3.5 kg/m(2). Mean follow-up was 33 months (range, 18-59 months). Preoperatively, the average lateral center edge angle, anterior center edge angle, and acetabular index were 10°, 14°, and 21°, respectively; 92% of patients had a Tönnis osteoarthritis grade of 0 or 1. One patient failed hip preservation surgery and went on to total hip arthroplasty 27 months after periacetabular osteotomy. Of the remaining patients, 71% reported an increase or no change in activity level postoperatively. The University of California-Los Angeles score was also unchanged (9.2 vs 8.8, P = .157), and the Harris Hip Score (63 vs 87, P < .001), Hip Dysfunction and Osteoarthritis Outcome Score-Quality of Life (38 vs 71, P < .001), and Western Ontario and McMaster Universities Osteoarthritis Index (71 vs 92, P < .001) results improved from preoperative levels. There was a 97% rate of satisfaction with the surgery. Four patients (11%) reported hip pain as the primary factor limiting postoperative activity.
The majority (71%) of active patients with hip dysplasia return to presurgical or higher activity levels after open hip preservation surgery with the periacetabular osteotomy.
髋臼周围截骨术是一种针对骨骼成熟患者有症状的髋臼畸形进行的详细描述的外科手术干预。关于该手术后恢复体育活动或运动的数据仍然有限。
评估髋臼周围截骨术后患者恢复到术前活动水平的能力。
病例系列；证据等级，4级。
这是一项对接受髋臼周围截骨术以矫正髋臼畸形的活跃患者的回顾性研究。患者被确定为术前加利福尼亚大学洛杉矶分校活动水平≥7级的患者。前瞻性记录患者的人口统计学数据、手术数据、影像学测量结果和临床结果。使用加利福尼亚大学洛杉矶分校活动评分、Harris髋关节评分、髋关节功能障碍和骨关节炎结果评分以及西安大略和麦克马斯特大学骨关节炎指数来测量临床结果，并分析有关活动和满意度的详细信息。
本研究纳入了36例患者（39髋；男性15例，女性21例），平均年龄25岁（范围15 - 45岁），平均体重指数为24±3.5kg/m²。平均随访33个月（范围18 - 59个月）。术前，平均外侧中心边缘角、前侧中心边缘角和髋臼指数分别为10°、14°和21°；92%的患者Tönnis骨关节炎分级为0或1级。1例患者保髋手术失败，在髋臼周围截骨术后27个月接受了全髋关节置换术。在其余患者中，71%报告术后活动水平增加或无变化。加利福尼亚大学洛杉矶分校评分也未改变（9.2对8.8，P = 0.157），而Harris髋关节评分（63对87，P < 0.001）、髋关节功能障碍和骨关节炎结果评分 - 生活质量（38对71，P < 0.001）以及西安大略和麦克马斯特大学骨关节炎指数（71对92，P < 0.001）结果较术前水平有所改善。手术满意度为97%。4例患者（11%）报告髋关节疼痛是限制术后活动的主要因素。
大多数（71%）活跃的髋关节发育不良患者在接受髋臼周围截骨术的开放性保髋手术后恢复到术前或更高的活动水平。
