Northumbria Healthcare NHS Foundation Trust, Ashington, UK.
Newcastle University, Newcastle Upon Tyne, UK.
Int Orthop. 2024 May;48(5):1225-1231. doi: 10.1007/s00264-024-06094-8. Epub 2024 Feb 26.
We conducted a retrospective analysis of prospectively collected data to evaluate (1) the extent of surgical correction following minimally invasive periacetabular osteotomy, (2) improvements in functional outcomes and any potential predictors for favourable outcome, and (3) complications after minimally invasive periacetabular osteotomy.
A total of 352 minimally invasive periacetabular osteotomy procedures were performed on 312 hip dysplasia patients between 2013 and 2020. Radiological parameters such as lateral centre edge angle, acetabular index, and Tönnis grade of arthritis were calculated. Patients also completed a range of patient reported outcome measures. Wilcoxon signed-rank tests were performed to assess for differences between patient reported outcome measures and radiological outcomes across the follow-up periods. Univariate linear regression and logistic regression were used to assess for predictors of change in functional outcome.
Patients had a significant correction in mean lateral centre edge angle from 17.2° to 35.3° (p < 0.001) and mean acetabular index from 13.2° to - 0.82°. At one year follow-up all patient reported outcome measures were significantly greater than their baseline measurements and this improvement was maintained at two years. Changes in patient reported outcome measures were independent of radiological parameters such as change in the lateral centre edge angle and acetabular index, pre-operative Tönnis grade, and patient factors such as age and sex. A total of 5.11% of patients developed post-operative complications, with four requiring posterior column fixation. Four patients (1.12%) needed a total hip replacement.
Minimally invasive periacetabular osteotomy is a safe procedure that provides significant functional outcome improvements following surgery at six months which is maintained at two years. More than three-fourths of patients achieved improvement of iHOT-12 score beyond the minimal clinically important difference and more than half of the patients achieved substantial clinical benefit for iHOT-12 score.
我们对前瞻性收集的数据进行回顾性分析，以评估（1）微创髋臼周围截骨术后的手术矫正程度，（2）功能结果的改善以及任何有利结果的潜在预测因素，以及（3）微创髋臼周围截骨术后的并发症。
2013 年至 2020 年间，对 312 例髋关节发育不良患者的 352 例微创髋臼周围截骨术进行了分析。计算了侧中心边缘角、髋臼指数和关节炎 Tönnis 分级等影像学参数。患者还完成了一系列患者报告的结果测量。Wilcoxon 符号秩检验用于评估随访期间患者报告的结果测量和影像学结果之间的差异。单变量线性回归和逻辑回归用于评估功能结果变化的预测因素。
患者的平均侧中心边缘角从 17.2°显著矫正至 35.3°（p<0.001），平均髋臼指数从 13.2°矫正至-0.82°。在一年的随访中，所有患者报告的结果测量都明显高于基线测量值，这种改善在两年时得到维持。患者报告的结果测量的变化与影像学参数（如侧中心边缘角和髋臼指数的变化、术前 Tönnis 分级以及患者因素（如年龄和性别））无关。共有 5.11%的患者发生术后并发症，其中 4 例需要后柱固定。有 4 例（1.12%）需要全髋关节置换。
微创髋臼周围截骨术是一种安全的手术，术后 6 个月功能结果显著改善，并在两年时得到维持。超过四分之三的患者 iHOT-12 评分改善超过了最小临床重要差异，超过一半的患者 iHOT-12 评分有显著的临床获益。
