关节镜下盂唇修复对髋臼周围截骨患者自我报告结局的影响。
The Effects of Arthroscopic Labral Repair on Patient-Reported Outcomes in the Setting of Periacetabular Osteotomy.
作者信息
Flemig Alison J Dittmer, Selley Ryan S, Essilfie Anthony, Robustelli Stacy, Schneider Brandon L, Ranawat Anil, Nawabi Danyal, Kelly Bryan T, Sink Ernest L
机构信息
Gillette Children's Specialty Healthcare, St. Paul, Minnesota, USA.
Northwestern Memorial Hospital, Chicago, Illinios, USA.
出版信息
Am J Sports Med. 2023 Apr;51(5):1217-1223. doi: 10.1177/03635465231156189. Epub 2023 Mar 16.
BACKGROUND
It is currently unknown whether the addition of arthroscopic labral repair in the setting of periacetabular osteotomy (PAO) provides any clinical benefit.
PURPOSE/HYPOTHESIS: The purpose of this study was to compare outcomes of patients who underwent arthroscopic labral repair concomitantly with PAO versus patients who underwent PAO alone. We hypothesized that there would be no difference in patient-reported outcome measures (PROMs) between the cohorts.
STUDY DESIGN
Cohort study; Level of evidence, 3.
METHODS
Patients undergoing PAO from a single-center prospective hip preservation registry were eligible for this study if they completed pre- and postoperative PROMs (minimum, 1 year). PROMs were collected at 1 year, 2 years, and latest follow-up at 6.05 years for PAO group and 4.2 years for scope/PAO group. The study group consisted of 53 patients who underwent arthroscopic labral repair at the time of their PAO, and the comparison group consisted of 170 patients who underwent PAO alone. A subset of the PAO group who had radiologic evidence of a detached labral tear (n = 33) was also compared with the rest of the PAO-alone group. PROMs were compared at every time point for both groups as well as the subset of patients who underwent PAO alone despite a labral tear.
RESULTS
The mean follow-up of all patients was 2 years (range, 1-6 years). Overall, 85.2% of the PAO group and 85.7% of the scope/PAO group met the minimal clinically important difference for either the modified Harris Hip Score (mHHS) or the International Hip Outcome Tool (iHOT-33) at the most recent follow-up. There was no difference in improvement between groups (mHHS, = .670; iHOT-33, = .944). Patients who had a radiologically diagnosed detached labral tear and underwent PAO alone had no difference in outcomes when compared with the rest of the PAO cohort (mHHS, = .981; iHOT-33, = .909).
CONCLUSION
There was no significant benefit measured by PROMs at follow-up for concomitant arthroscopic labral repair in the setting of PAO.
背景
目前尚不清楚在髋臼周围截骨术（PAO）中增加关节镜下盂唇修复是否能带来临床益处。
目的/假设：本研究的目的是比较同时接受关节镜下盂唇修复和PAO的患者与仅接受PAO的患者的治疗结果。我们假设两组患者报告的结局指标（PROMs）没有差异。
研究设计
队列研究；证据等级，3级。
方法
来自单中心前瞻性髋关节保留登记处且接受PAO的患者，如果他们完成了术前和术后的PROMs（最短1年），则符合本研究条件。PAO组在1年、2年以及6.05年的最新随访时收集PROMs，关节镜/PAO组在4.2年的最新随访时收集。研究组由53例在PAO时接受关节镜下盂唇修复的患者组成，对照组由170例仅接受PAO的患者组成。PAO组中有放射学证据显示盂唇撕裂分离的一个亚组（n = 33）也与其余仅接受PAO的组进行了比较。在每个时间点对两组以及尽管有盂唇撕裂但仅接受PAO的患者亚组的PROMs进行比较。
结果
所有患者的平均随访时间为2年（范围1 - 6年）。总体而言，在最近一次随访时，PAO组85.2%的患者和关节镜/PAO组85.7%的患者在改良Harris髋关节评分（mHHS）或国际髋关节结局工具（iHOT - 33）方面达到了最小临床重要差异。两组之间的改善情况没有差异（mHHS，P = 0.670；iHOT - 33，P = 0.944）。与其余PAO队列相比，有放射学诊断的盂唇撕裂分离且仅接受PAO的患者在结局方面没有差异（mHHS，P = 0.981；iHOT - 33，P = 0.909）。
结论
在PAO的情况下，随访时通过PROMs测量，同时进行关节镜下盂唇修复没有显著益处。
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