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采用托尼尼斯(Tönnis)和卡尔施密特(Kalchschmidt)技术行三联骨盆截骨术治疗残留髋关节发育不良后的体育活动

Sports activity after treatment of residual hip dysplasia with triple pelvic osteotomy using the Tönnis and Kalchschmidt technique.

作者信息

Ettinger Max, Berger Stefan, Floerkemeier Thilo, Windhagen Henning, Ezechieli Marco

机构信息

Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany

Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany.

出版信息

Am J Sports Med. 2015 Mar;43(3):715-20. doi: 10.1177/0363546514561434. Epub 2014 Dec 24.

Abstract

BACKGROUND

Pelvic osteotomies are performed to prevent the progression of osteoarthritis and its associated pain due to adult hip dysplasia, particularly for young patients with no or low-grade osteoarthritis. No data are available concerning levels of sporting activity before and after triple pelvic osteotomy (TPO). Therefore, the aim of this study was to provide comprehensive data on levels of sporting activity and the subjective outcome of patients after this complex operation.

HYPOTHESIS

Patients can return to a higher level of sports activity after TPO compared with their preoperative level.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Between 2003 and 2011, a total of 116 triple pelvic osteotomies were performed at a single institution; the Tönnis and Kalchschmidt technique was used on 91 patients. After exclusion criteria for this study were applied, 77 patients remained (59 females and 18 males); the mean ± SD age at operation was 26 ± 3.9 years. To study outcomes, patients were asked to complete both the Harris hip score (HHS) and the Hip disability and Osteoarthritis Outcome Score (HOOS) preoperatively and at postoperative follow-up. Their level of activity was determined according to the University of California, Los Angeles (UCLA) activity score. Patients rated their hip movement and overall satisfaction preoperatively and at postoperative follow-up using a visual analog scale for sporting activity, physical fitness level, and level of pain experienced while performing their sport.

RESULTS

The mean ± SD follow-up time was 6.2 ± 1.4 years. The mean HHS changed significantly from 63.3 ± 15.6 preoperatively to 90.1 ± 10.8 at follow-up (P < .001), and the mean HOOS changed significantly from 52.9 ± 20.1 to 82 ± 17.1 at follow-up (P < .001). The mean UCLA activity score changed significantly from 4.8 ± 2.1 to 7.7 ± 1.4 at follow-up (P < .001).

CONCLUSION

Patients achieved a higher level of sports activity postoperatively. The postoperative level of participation in sports was superior, with a shift from low- to high-impact activities.

摘要

背景

骨盆截骨术用于预防成人髋关节发育不良导致的骨关节炎进展及其相关疼痛,尤其适用于无骨关节炎或轻度骨关节炎的年轻患者。目前尚无关于三联骨盆截骨术(TPO)前后体育活动水平的数据。因此,本研究的目的是提供关于该复杂手术后患者体育活动水平和主观结果的全面数据。

假设

与术前水平相比,患者在TPO后可恢复到更高水平的体育活动。

研究设计

病例系列;证据等级,4级。

方法

2003年至2011年期间,在单一机构共进行了116例三联骨盆截骨术;91例患者采用了Tönnis和Kalchschmidt技术。应用本研究的排除标准后,剩余77例患者(59例女性和18例男性);手术时的平均年龄±标准差为26±3.9岁。为研究结果,要求患者在术前和术后随访时完成Harris髋关节评分(HHS)和髋关节残疾与骨关节炎结果评分(HOOS)。根据加利福尼亚大学洛杉矶分校(UCLA)活动评分确定他们的活动水平。患者在术前和术后随访时使用视觉模拟量表对髋关节活动、体育活动、身体健康水平以及运动时的疼痛程度进行评分,以评估他们的髋关节活动情况和总体满意度。

结果

平均随访时间±标准差为6.2±1.4年。HHS平均得分从术前的63.3±15.6显著变化为随访时的90.1±10.8(P <.001),HOOS平均得分从52.9±20.1显著变化为随访时的82±17.1(P <.001)。UCLA活动评分平均得分从随访前的4.8±2.1显著变化为7.7±1.4(P <.001)。

结论

患者术后达到了更高水平的体育活动。术后体育活动参与水平更高,从低强度活动转变为高强度活动。

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