Health Education North East England, Newcastle upon Tyne, England.
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, England.
J Bone Joint Surg Am. 2020 Aug 5;102(15):1312-1320. doi: 10.2106/JBJS.18.01387.
Periacetabular osteotomy (PAO) is a well-recognized procedure for the treatment of hip dysplasia in young adults and can be used for the surgical management of femoroacetabular impingement (FAI) with acetabular retroversion. The aim of this study was to use a national database to assess the outcomes of PAO for developmental dysplasia of the hip (DDH) and for FAI.
All patients in whom an isolated PAO had been performed between January 2012 and February 2019 were identified in the Non-Arthroplasty Hip Registry (NAHR). Their outcomes were assessed using the EuroQol-5 Dimensions (EQ-5D) index and the International Hip Outcome Tool (iHOT)-12 preoperatively and then at 6 months, 12 months, and 2 years postoperatively.
Six hundred and thirty (630) PAOs were identified, with 558 (89%) performed for DDH and 72 (11%) performed for FAI. Most patients (90%) were female. The mean age in the DDH group (31.2 years) was significantly higher (p < 0.0001) than that in the FAI group (26.5 years). There were no other significant between-group demographic differences. Preoperatively and at each follow-up time-period, iHOT-12 scores were better in the DDH group than in the FAI group; however, only the preoperative scores differed significantly. There was significant improvement between the preoperative and 6-month iHOT-12 and EQ-5D index scores in both the DDH and the FAI group. This improvement was maintained at 12 months postoperatively, by which time almost 90% of the patients had achieved the minimum clinically important difference (MCID) in their iHOT-12 score.
This study shows that PAO is a successful surgical intervention for DDH and FAI in the short term, with significant improvement in patient-reported outcome scores that is maintained up to 2 years postoperatively.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
髋臼周围截骨术（PAO）是治疗年轻成人髋关节发育不良的一种公认方法，也可用于治疗髋臼后倾的股骨髋臼撞击症（FAI）。本研究旨在使用国家数据库评估 PAO 治疗发育性髋关节发育不良（DDH）和 FAI 的疗效。
在非关节置换髋关节登记处（NAHR）中，确定了 2012 年 1 月至 2019 年 2 月期间接受单纯 PAO 的所有患者。使用欧洲五维健康量表（EQ-5D）指数和国际髋关节结果工具（iHOT）-12 对其术前、术后 6 个月、12 个月和 2 年的结果进行评估。
共确定了 630 例 PAO，其中 558 例（89%）用于治疗 DDH，72 例（11%）用于治疗 FAI。大多数患者（90%）为女性。DDH 组的平均年龄（31.2 岁）明显高于 FAI 组（26.5 岁）（p < 0.0001）。两组之间在其他人口统计学特征方面无明显差异。在术前和每个随访时间段，DDH 组的 iHOT-12 评分均优于 FAI 组；然而，仅术前评分差异有统计学意义。在 DDH 和 FAI 组中，与术前相比，iHOT-12 和 EQ-5D 指数评分在术后 6 个月时均有显著改善。术后 12 个月时，这种改善仍在维持，此时几乎 90%的患者 iHOT-12 评分达到了最小临床重要差异（MCID）。
本研究表明，PAO 是治疗 DDH 和 FAI 的一种成功的手术干预措施，患者报告的结果评分在短期内在不断改善，并且在术后 2 年内保持稳定。
治疗性 IV 级。请参阅作者说明以获取完整的证据等级描述。
