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骨盆截骨术治疗发育性髋关节发育不良后的体育活动:三联骨盆截骨术与髋臼周围截骨术技术的比较研究。

Sports activity after pelvic osteotomy for treatment of developmental dysplasia of the hip : A comparative study between the triple pelvic and periacetabular osteotomy techniques.

机构信息

Department of Orthopaedic Surgery, Diakovere Annastift (Hannover Medical School), Hannover, Germany.

Department of Orthopaedic Surgery, Klinikum Bethel, Bielefeld, Germany.

出版信息

Orthopadie (Heidelb). 2022 Sep;51(9):775-780. doi: 10.1007/s00132-022-04249-2. Epub 2022 Apr 8.

Abstract

BACKGROUND

Symptomatic dysplasia of the hip represents an indication for a bony correction of the acetabulum. In the last decades several operative procedures were established.

OBJECTIVE

The aim of the current study was to analyze whether the level of sports activity is higher in patients after periacetabular osteotomy (PAO) according to Ganz as a technique which preserves the posterior column compared to classical triple pelvic osteotomy (TPO) for treatment of developmental hip dysplasia.

MATERIAL AND METHODS

The study group included 102 patients treated with the classical TPO with already published clinical results, who were compared to 34 patients treated with PAO between 2012 and 2016. The clinical outcome scores included the modified Harris Hip Score, the Hip Osteoarthritis Outcome Score, the University of California, Los Angeles activity score and the visual analog scale.

RESULTS

After a mean follow-up of 4.4 years the clinical parameters improved significantly after PAO (p < 0.05). In comparison to the TPO group the clinical scores of the PAO group had inferior baseline values and a tendency to inferior follow-up results in the mHHS (p < 0.05) and HOOS (p > 0.05). After surgery, the PAO group showed a shift to medium and high impact sport activities.

CONCLUSION

The shorter time of postoperative partial weight bearing after PAO due to the preservation of the posterior column seemed not to have a positive impact on the clinical results or the sports activity compared to the TPO treated patients.

摘要

背景

髋关节症状性发育不良代表了髋臼骨性矫正的适应证。在过去的几十年中,已经建立了几种手术方法。

目的

本研究旨在分析髋臼周围截骨术(PAO)作为一种保留后柱的技术与经典三联骨盆截骨术(TPO)治疗发育性髋关节发育不良相比,是否能使患者的体育活动水平更高。

材料和方法

研究组包括 102 例接受经典 TPO 治疗且已有临床结果发表的患者,并与 2012 年至 2016 年期间接受 PAO 治疗的 34 例患者进行比较。临床结果评分包括改良 Harris 髋关节评分、髋关节骨关节炎结果评分、加利福尼亚大学洛杉矶活动评分和视觉模拟评分。

结果

平均随访 4.4 年后,PAO 后的临床参数显著改善(p<0.05)。与 TPO 组相比,PAO 组的临床评分基线值较低,改良 Harris 髋关节评分(mHHS)(p<0.05)和髋关节骨关节炎结果评分(HOOS)(p>0.05)的随访结果有下降趋势。手术后,PAO 组倾向于从事中高强度的体育活动。

结论

PAO 由于保留了后柱,术后部分负重的时间较短,但与 TPO 治疗的患者相比,这似乎对临床结果或体育活动没有积极影响。

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