Swarup Ishaan, Zaltz Ira, Robustelli Stacy, Sink Ernest
Division of Pediatric Orthopaedic Surgery, UCSF Benioff Children's Hospital, 747 52nd Street, Oakland, CA 94609, USA.
Division of Pediatric Orthopaedic Surgery, William Beaumont Hospital, 3501 West 13, Mile Road, Royal Oak, MI 48073, USA.
J Hip Preserv Surg. 2020 Apr 2;7(2):249-255. doi: 10.1093/jhps/hnaa012. eCollection 2020 Jul.
Treatment of borderline acetabular dysplasia (lateral center edge angle ≥18°) remains controversial, and there is a paucity of literature focusing on outcomes in adolescent patients. The purpose of this study was to evaluate the outcomes of a periacetabular osteotomy (PAO) as surgical management of borderline acetabular dysplasia in adolescent patients. We performed a retrospective review of prospectively collected data and included patients ≤ 21 years of age that underwent PAO for borderline acetabular dysplasia. All patients had a minimum of 1-year follow-up. Outcomes were assessed using modified Harris Hip Scores (mHHS), Hip Outcome Scores (HOS) and international Hip Outcome Tool (iHOT-33). Descriptive and univariate statistical analyses were performed. This study included 33 adolescent patients (35 hips) with symptomatic, borderline acetabular dysplasia. The majority of patients was female (32 patients, 97%); half of all patients reported a history of hip pain for over 1 year; and seven patients had previous hip arthroscopy. In addition to PAO, seven hips (20%) underwent a concurrent hip arthroscopy at the time of surgery. There were significant improvements in mean mHHS, HOS-activities of daily living (ADL), HOS-Sport and iHOT-33 scores after surgery ( < 0.01). Minimal clinically important difference in outcome scores was achieved for over 90% of patients at a minimum of 1-year follow-up. Borderline acetabular dysplasia is a major cause of hip pain in adolescent patients. Patients with symptomatic borderline acetabular dysplasia report a significant benefit after a PAO to correct structural hip instability.
边缘性髋臼发育不良（外侧中心边缘角≥18°）的治疗仍存在争议，且针对青少年患者治疗结果的文献较少。本研究的目的是评估髋臼周围截骨术（PAO）作为青少年边缘性髋臼发育不良手术治疗方法的效果。我们对前瞻性收集的数据进行了回顾性分析，纳入了年龄≤21岁、因边缘性髋臼发育不良接受PAO手术的患者。所有患者均至少随访1年。采用改良Harris髋关节评分（mHHS）、髋关节结局评分（HOS）和国际髋关节结局工具（iHOT-33）评估治疗结果。进行了描述性和单变量统计分析。本研究纳入了33例有症状的边缘性髋臼发育不良青少年患者（35髋）。大多数患者为女性（32例，97%）；所有患者中有一半报告髋关节疼痛病史超过1年；7例患者曾接受过髋关节镜检查。除PAO外，7髋（20%）在手术时同时接受了髋关节镜检查。术后平均mHHS、HOS日常生活活动（ADL）评分、HOS运动评分和iHOT-33评分均有显著改善（<0.01）。在至少1年的随访中，超过90%的患者在结局评分上达到了最小临床重要差异。边缘性髋臼发育不良是青少年髋关节疼痛的主要原因。有症状的边缘性髋臼发育不良患者在接受PAO以纠正髋关节结构不稳定后，报告有显著获益。
