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髋臼发育不良的描述性流行病学:髋关节保守治疗结果研究学术网络(ANCHOR)髋臼周围截骨术

Descriptive Epidemiology of Acetabular Dysplasia: The Academic Network of Conservational Hip Outcomes Research (ANCHOR) Periacetabular Osteotomy.

作者信息

Sankar Wudbhav N, Duncan Stephen T, Baca Geneva R, Beaulé Paul E, Millis Michael B, Kim Young-Jo, Peters Christopher L, Podeszwa David A, Schoenecker Perry L, Sierra Rafael J, Sink Ernest L, Sucato Daniel J, Trousdale Robert T, Zaltz Ira, Clohisy John C

机构信息

From the Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA (Dr. Sankar); the Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY (Dr. Duncan), the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO (Ms. Baca, Dr. Schoenecker and Dr. Clohisy), the Department of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada (Dr. Beaulé), the Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA (Dr. Millis and Dr. Kim), the Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT (Dr. Peters), the Department of Orthopaedic Surgery, Texas Scottish Rite Hospital, Dallas, TX (Dr. Podeszwa and Dr. Sucato), the Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN (Dr. Sierra and Dr. Trousdale), the Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY (Dr. Sink), and the Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, MI (Dr. Zaltz).

出版信息

J Am Acad Orthop Surg. 2017 Feb;25(2):150-159. doi: 10.5435/JAAOS-D-16-00075.

Abstract

BACKGROUND

Periacetabular osteotomy (PAO) is an established treatment for symptomatic acetabular dysplasia, which is a well-recognized cause of hip pain, functional limitations, and secondary osteoarthritis. The purpose of this study was to describe the demographics of patients undergoing PAO, the baseline patient-reported outcome measures for this population, and the types of adjunctive procedures performed at the time of PAO surgery.

METHODS

Demographics, disease characteristics, and patient-reported functional measures were prospectively collected from all patients who underwent PAO performed by 12 surgeons from 2008 to 2013.

RESULTS

We enrolled 950 consecutive patients (982 hips) in the study; 83% were female and 17% were male, with an average age of 25.3 years and an average body mass index (BMI) of 24.6 kg/m. Most patients were Caucasian (87%), and 15% had undergone previous hip surgery. Before PAO was performed, most patients had had symptoms for 1 to 3 years. Baseline modified Harris Hip and University of California Los Angeles activity scores (61.8 and 6.6, respectively) indicated that patients had considerable functional limitations.

DISCUSSION

Patients undergoing PAO for symptomatic dysplasia were predominantly young, female, and Caucasian with a normal BMI. Many patients had undergone prior hip surgery, and most had had symptoms for several years before treatment. Baseline patient-reported functional scores demonstrated marked functional limitations. Adjunctive procedures for intra-articular pathology, especially femoral osteochondroplasty and hip arthroscopy, are commonly performed at the time of PAO.

摘要

背景

髋臼周围截骨术(PAO)是治疗有症状的髋臼发育不良的既定方法,髋臼发育不良是导致髋关节疼痛、功能受限及继发性骨关节炎的一个公认原因。本研究的目的是描述接受PAO手术患者的人口统计学特征、该人群的基线患者报告结局指标,以及PAO手术时所进行的辅助手术类型。

方法

前瞻性收集了2008年至2013年由12位外科医生实施PAO手术的所有患者的人口统计学特征、疾病特点及患者报告的功能指标。

结果

我们连续纳入了950例患者(982髋)进行研究;83%为女性,17%为男性,平均年龄25.3岁,平均体重指数(BMI)为24.6kg/m²。大多数患者为白种人(87%),15%曾接受过髋关节手术。在进行PAO手术前,大多数患者已出现症状1至3年。基线改良Harris髋关节评分和加州大学洛杉矶分校活动评分(分别为61.8和6.6)表明患者存在明显的功能受限。

讨论

因有症状的发育不良而接受PAO手术治疗的患者主要为年轻、女性、白种人且BMI正常。许多患者曾接受过髋关节手术,且大多数患者在治疗前已出现症状数年。基线患者报告的功能评分显示存在明显的功能受限。在PAO手术时,通常会针对关节内病变进行辅助手术,尤其是股骨骨软骨成形术和髋关节镜检查。

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