Haynes Jacob A, Pascual-Garrido Cecilia, An Tonya W, Nepple Jeffrey J, Clohisy John C
Anderson Orthopaedic Clinic - Mount Vernon, 2501 Parker's Ln, 200, Alexandria, VA, USA.
Washington University School of Medicine, 660 S. Euclid Ave CB 8233, St. Louis, MO, USA.
J Hip Preserv Surg. 2018 Sep 7;5(3):267-273. doi: 10.1093/jhps/hny026. eCollection 2018 Aug.
Hip arthroscopy is increasingly utilized in the treatment of symptomatic intra-articular hip pathology. Unaddressed development dysplasia of the hip (DDH) is thought to be associated with failure after hip arthroscopy. The aims of this study were (i) to identify the prevalence of previous failed hip arthroscopy in patients undergoing a periactebaular osteotomy (PAO) for the treatment of symptomatic acetabular dysplasia, (ii) report on the temporal trend of failed ipsilateral hip arthroscopy in patients undergoing PAO and (iii) to determine clinical and radiographic characteristics associated with utilization of isolated hip arthroscopy in patients with acetabular dysplasia. We identified 139 patients undergoing PAO who had a history of a prior ipsilateral hip arthroscopy. A comparison group of 1505 patients with a diagnosis of acetabular dysplasia, who underwent PAO alone without any prior ipsilateral surgery during the study period was used. Clinical characteristics, radiographic and intraoperative findings were compared between cohorts. From 2008 to 2015, the rate of previous failed hip arthroscopy in patients undergoing subsequent PAO increased steadily until 2013 with a maximum of 12%. Patients in the study group had mild dysplasia with significantly higher LCEA (17.2° versus 11.3°; < 0.001) and ACEA (15.6° versus 10.8°; < 0.001), a lower acetabular inclination (14.0° versus 19.0°; < 0.001). The findings illustrate a constant increase in the rate of failed hip arthroscopy in the setting of acetabular dysplasia from 2008 till 2013. Female sex and mild dysplasia were associated with use of isolated hip arthroscopy in the setting of acetabular dysplasia.
髋关节镜检查在有症状的关节内髋关节病变治疗中应用日益广泛。未得到治疗的髋关节发育不良(DDH)被认为与髋关节镜检查术后失败有关。本研究的目的是:(i)确定因有症状的髋臼发育不良而接受髋臼周围截骨术(PAO)的患者中既往髋关节镜检查失败的发生率;(ii)报告接受PAO的患者同侧髋关节镜检查失败的时间趋势;(iii)确定髋臼发育不良患者单纯髋关节镜检查应用相关的临床和影像学特征。我们确定了139例接受PAO且有同侧髋关节镜检查史的患者。使用了一个由1505例诊断为髋臼发育不良的患者组成的对照组,这些患者在研究期间仅接受了PAO,未进行任何同侧手术。对两组患者的临床特征、影像学和术中发现进行了比较。从2008年到2015年,接受后续PAO的患者中既往髋关节镜检查失败率稳步上升,直到2013年达到最高的12%。研究组患者髋臼发育不良程度较轻,外侧中心边缘角(LCEA)显著更高(17.2°对11.3°;P<0.001),髋臼角(ACEA)也显著更高(15.6°对10.8°;P<0.001),髋臼倾斜度更低(14.0°对19.0°;P<0.001)。研究结果表明,从2008年到2013年,髋臼发育不良患者中髋关节镜检查失败率持续上升。女性和轻度发育不良与髋臼发育不良患者单纯髋关节镜检查的应用有关。