Université de Lille Nord de France, 59000, Lille, France.
Service d'Orthopédie 2, Hôpital Salengro, CHRU de Lille, Place de Verdun, 59037, Lille, France.
Int Orthop. 2022 May;46(5):989-997. doi: 10.1007/s00264-022-05322-3. Epub 2022 Feb 3.
Total hip arthroplasty (THA) in young adults, especially in those with hip dysplasia, is affected by wear and acetabular fixation problems. Shelf acetabuloplasty is performed to delay THA in patients with acetabular dysplasia. Thus, we conducted a retrospective, continuous case-control study at a single healthcare facility to analyze (1) the influence of prior shelf acetabuloplasty on the survival of a subsequent THA and (2) the functional outcomes.
We evaluated 105 patients (124 THA) who underwent THA due to hip dysplasia: 54 patients (61 THA) were included in the THA post-shelf acetabuloplasty group (case group) and 51 patients (63 THA) in the THA for dysplasia group (control group).
At 15 years' follow-up, 89% of patients (95% CI: 84-91%) in the shelf group and 83% (95% CI: 81-90%) in the dysplasia group had not undergone surgical revision. This difference between groups was not statistically significant (p = 0.566). The functional outcomes were satisfactory in both groups; however, they were significantly better in the dysplasia group than in the shelf group based on the Merle d'Aubigne and Postel score (16.9 vs 16.0 min-max: 14-18 vs 3-18) (p = 0.01), Harris Hip score (90.0 vs 84.7, min-max: 62-100 vs 22-100) (p = 0.017), and the Oxford-12 (18/60 vs 21/60, min-max: 45-12 vs 51-12) (p = 0.04).
Shelf acetabuloplasty before THA does not negatively affect THA survivorship. The functional outcomes appear to be better in the hips that did not undergo shelf acetabuloplasty, although the results were good in both groups.
全髋关节置换术（THA）在年轻患者中，尤其是髋关节发育不良的患者中，受到磨损和髋臼固定问题的影响。髋臼架成形术用于延迟髋臼发育不良患者的 THA。因此，我们在一家医疗机构进行了回顾性、连续的病例对照研究，分析（1）髋臼架成形术前对随后 THA 生存率的影响，以及（2）功能结果。
我们评估了 105 例（124 例 THA）因髋关节发育不良而接受 THA 的患者：54 例（61 例 THA）患者纳入髋臼架成形术后 THA 组（病例组），51 例（63 例 THA）患者纳入髋臼发育不良 THA 组（对照组）。
在 15 年的随访中，髋臼架组 89%（95%可信区间：84-91%）的患者和髋臼发育不良组 83%（95%可信区间：81-90%）的患者未进行手术翻修。两组间差异无统计学意义（p=0.566）。两组的功能结果均满意，但髋臼发育不良组的 Merle d'Aubigne 和 Postel 评分（16.9 分，最小值-最大值：14-18 分比 3-18 分）、Harris 髋关节评分（90.0 分，最小值-最大值：62-100 分比 22-100 分）和牛津-12 评分（18/60 分，最小值-最大值：45-12 分比 51-12 分）均显著优于髋臼架组（p=0.01、p=0.017 和 p=0.04）。
THA 前髋臼架成形术不会对 THA 的生存率产生负面影响。尽管两组的结果都很好，但未行髋臼架成形术的髋关节功能结果似乎更好。
