髋臼盂唇撕裂会影响髋臼发育不良患者行髋臼周围截骨术后的不良预后吗?
Do labral tears influence poor outcomes after periacetabular osteotomy for acetabular dysplasia?
作者信息
Hagio T, Naito M, Nakamura Y, Muraoka K
机构信息
Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
出版信息
Bone Joint J. 2016 Jun;98-B(6):741-6. doi: 10.1302/0301-620X.98B6.36034.
AIMS
Acetabular dysplasia is frequently associated with intra-articular pathology such as labral tears, but whether labral tears should be treated at the time of periacetabular osteotomy (PAO) remains controversial. The purpose of this study was to compare the clinical outcomes and radiographic corrections of PAO for acetabular dysplasia between patients with and without labral tears pre-operatively.
PATIENTS AND METHODS
We retrospectively reviewed 70 hips in 67 patients with acetabular dysplasia who underwent PAO. Of 47 hips (45 patients) with labral tears pre-operatively, 27 (25 patients) underwent PAO alone, and were classified as the labral tear alone (LT) group, and 20 (20 patients) underwent combined PAO and osteochondroplasty, and were classified as the labral tear osteochondroplasty (LTO) group. The non-labral tear (NLT) group included 23 hips in 22 patients.
RESULTS
There were no significant differences between groups for post-operative Harris hip scores, degree of progression of osteoarthritis or rate of reoperation. The pre-operative alpha angle was significantly larger in the LTO group compared with the other groups (p < 0.0001).
CONCLUSION
PAO provides equivalent short-term relief of pain and functional outcome in patients with or without labral tears. The rate of progression of osteoarthritis and reoperation was not significantly increased in patients with labral tears.
TAKE HOME MESSAGE
PAO provides equivalent short-term pain relief and functional outcomes in patients with acetabular dysplasia with and without labral tears. We did not find significantly increased risks of progression of osteoarthritis or re-operation in those with labral tears. Cite this article: Bone Joint J 2016;98-B:741-6.
目的
髋臼发育不良常与关节内病变如盂唇撕裂相关,但在髋臼周围截骨术(PAO)时是否应治疗盂唇撕裂仍存在争议。本研究的目的是比较术前有或无盂唇撕裂的髋臼发育不良患者接受PAO后的临床结果和影像学矫正情况。
患者与方法
我们回顾性分析了67例接受PAO的髋臼发育不良患者的70个髋关节。术前47个髋关节(45例患者)存在盂唇撕裂,其中27个(25例患者)仅接受PAO,被分类为单纯盂唇撕裂(LT)组,20个(20例患者)接受PAO联合骨软骨成形术,被分类为盂唇撕裂骨软骨成形术(LTO)组。非盂唇撕裂(NLT)组包括22例患者的23个髋关节。
结果
术后Harris髋关节评分、骨关节炎进展程度或再次手术率在各组之间无显著差异。与其他组相比,LTO组术前的α角明显更大(p < 0.0001)。
结论
PAO在有或无盂唇撕裂的患者中提供了同等程度的短期疼痛缓解和功能结果。盂唇撕裂患者骨关节炎的进展率和再次手术率没有显著增加。
要点
PAO在有或无盂唇撕裂的髋臼发育不良患者中提供了同等程度的短期疼痛缓解和功能结果。我们未发现盂唇撕裂患者骨关节炎进展或再次手术的风险显著增加。引用本文:《骨与关节杂志》2016年;98 - B:741 - 6。