Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea; Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Republic of Korea.
Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea; Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
J Arthroplasty. 2020 Oct;35(10):2807-2812. doi: 10.1016/j.arth.2020.05.045. Epub 2020 May 27.
Although the long-term results of periacetabular osteotomy in acetabular dysplasia have been well documented, there is paucity in reports on the long-term outcomes of periacetabular osteotomy with simultaneous hip arthroscopy. This study aimed to assess the cumulative 10-year outcomes of periacetabular rotational osteotomy with concomitant hip arthroscopy.
Through an arthroscopic procedure, the status of the labrum was assessed, and torn labrum was debrided. Evaluations on survival from conversion to total hip arthroplasty and success in radiographic and clinical long-term results were completed in 39 hips (36 patients). Acetabular parameters (center-edge angle, Sharp angle, acetabular-head index, and head lateralization index), Tönnis grades on radiograph, Harris Hip Score, and range of motion of the hip were evaluated. Survivorship analyses were evaluated with the Kaplan-Meier method.
Thirty-eight hips (97.4%, 95% confidence interval 0.832-0.996) were preserved for 12.8 ± 1.7 years on average, and only 1 hip was converted to total hip arthroplasty at 7.8 years. All the acetabular parameters were improved (P < .001). Twenty-eight hips (71.8%) showed unchanged or improved Tönnis grades at the latest follow-up. The average Harris Hip Score was significantly better than the preoperative value (P < .001), and range of motion was not significantly different until the latest follow-up.
Sufficient acetabular reorientation, such as periacetabular rotational osteotomy, with concomitant arthroscopic debridement showed successful long-term outcomes for acetabular dysplasia in adults.
尽管髋臼发育不良患者行髋臼周围截骨术的长期疗效已有大量文献报道，但同期行髋臼周围截骨术联合髋关节镜治疗的长期疗效报告却很少。本研究旨在评估髋臼周围旋转截骨术同期行髋关节镜治疗的 10 年累积结果。
通过关节镜手术评估盂唇状态，并切除撕裂的盂唇。对 39 髋（36 例患者）进行了从转换为全髋关节置换术的生存情况评估以及影像学和临床长期结果的成功评估。评估髋臼参数（中心边缘角、Sharp 角、髋臼头指数和股骨头侧位指数）、影像学 Tönnis 分级、Harris 髋关节评分和髋关节活动范围。采用 Kaplan-Meier 方法进行生存分析。
38 髋（97.4%，95%置信区间 0.832-0.996）平均保留 12.8±1.7 年，仅 1 髋在 7.8 年时转换为全髋关节置换术。所有髋臼参数均得到改善（P<0.001）。28 髋（71.8%）在末次随访时 Tönnis 分级不变或改善。平均 Harris 髋关节评分为明显优于术前值（P<0.001），且直至末次随访时活动范围无明显差异。
充分的髋臼再定位，如髋臼周围旋转截骨术联合关节镜下清创术，可成功治疗成人髋臼发育不良。
