Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
Bone Joint J. 2024 May 1;106-B(5 Supple B):11-16. doi: 10.1302/0301-620X.106B5.BJJ-2023-0621.R1.
Lateral femoral cutaneous nerve (LFCN) injury is a complication after periacetabular osteo-tomy (PAO) using an anterior approach, which might adversely affect the outcome. However, no prospective study has assessed the incidence and severity of this injury and its effect on the clinical outcomes over a period of time for longer than one year after PAO. The aim of this study was to assess the incidence and severity of the symptoms of LFCN injury for ≥ three years after PAO and report its effect on clinical outcomes.
A total of 40 hips in 40 consecutive patients who underwent PAO between May 2016 and July 2018 were included in the study, as further follow-up of the same patients from a previous study. We prospectively evaluated the incidence, severity, and area of symptoms following LFCN injury. We also recorded the clinical scores at one year and ≥ three years postoperatively using the 36-Item Short Form Health Survey (SF-36) and Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) scores.
A total of 20 patients (50%) had symptoms of a LFCN injury at one year after PAO. At ≥ three years postoperatively, the symptoms had completely resolved in seven of these patients and 13 (33%) had persistent symptoms. The severity and area of symptoms did not significantly differ between one and ≥ three years postoperatively. The JHEQ showed significant differences in the patient satisfaction and mental scores between those with and those without sypmtoms of LFCN injury at ≥ three years postoperatively, while there was no significant difference in the mean SF-36 scores.
The incidence of LFCN injury after PAO using an anterior approach is high. The outcome of PAO, ≥ three years postoperatively, is poorer in patients with persistent symptoms from a perioperative LFCN injury, in that patient satisfaction and mental health scores are adversely affected.
股外侧皮神经（LFCN）损伤是经前路髋臼周围截骨术（PAO）的一种并发症，可能会对结果产生不利影响。然而，尚无前瞻性研究评估这种损伤的发生率和严重程度，以及其对 PAO 后超过一年时间内的临床结果的影响。本研究旨在评估 PAO 后≥3 年 LFCN 损伤症状的发生率和严重程度，并报告其对临床结果的影响。
本研究共纳入 2016 年 5 月至 2018 年 7 月期间接受 PAO 的 40 髋 40 例连续患者，为先前研究中同一批患者的进一步随访。我们前瞻性评估了 LFCN 损伤后症状的发生率、严重程度和区域。我们还使用 36 项简短健康调查（SF-36）和日本矫形协会髋关节疾病评估问卷（JHEQ）评分记录了术后 1 年和≥3 年的临床评分。
共有 20 例患者（50%）在 PAO 后 1 年出现 LFCN 损伤症状。在术后≥3 年时，其中 7 例患者的症状完全缓解，13 例（33%）患者仍有持续症状。术后 1 年和≥3 年时症状的严重程度和区域无显著差异。在术后≥3 年时，有和无 LFCN 损伤症状的患者在患者满意度和精神评分方面 JHEQ 存在显著差异，而 SF-36 评分无显著差异。
经前路 PAO 后 LFCN 损伤的发生率较高。术后≥3 年时，持续存在 LFCN 损伤症状的患者 PAO 结果较差，因为患者满意度和心理健康评分受到不利影响。
