Serna Juan, Furie Kira, Wong Stephanie E, Swarup Ishaan, Zhang Alan L, Diab Mohammad
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Mar 26;6(3):100929. doi: 10.1016/j.asmr.2024.100929. eCollection 2024 Jun.
To analyze the annual use of hip arthroscopy (HA) and Bernese periacetabular osteotomy (PAO) for the treatment of hip dysplasia (HD), as well as postoperative outcomes, including ipsilateral reoperations.
, and , codes were used to query the PearlDiver Mariner database from January 2010 through January 2022 to identify patients aged 10 to 59 years who had a presenting diagnosis of HD and subsequently underwent (1) HA; (2) PAO; or (3) combined HA and PAO (HA-PAO, defined as PAO on the same day or within 28 days after HA). We analyzed annual rates for each treatment, as well as rates of postoperative emergency visits, readmissions, and 5-year ipsilateral secondary operations (determined via Kaplan-Meier analysis).
There were 32,068 patients who underwent surgical treatment of HD. For HA, PAO, and HA-PAO, there were 29,700, 2,083, and 285 patients, respectively. All operations had the greatest percent-increase from 2015 to 2016. HA and HA-PAO peaked in 2021, whereas PAO peaked in 2019. For HA, PAO, and HA-PAO, most cases were performed in female patients and patients aged 30 to 49 years, 10 to 19 years, and 10 to 29 years, respectively. The 5-year incidence of ipsilateral secondary operations, which include revision HA, PAO, or conversion to total hip arthroplasty, was 9.2% (95% confidence interval 8.6%-9.8%) in the HA group and 6.5% (95% confidence interval 4.1%-8.8%) in the PAO group. Combining HA with PAO resulted in so few secondary operations that Kaplan-Meier analysis was infeasible. The PAO cohort had the greatest 30-day emergency visit and 90-day readmission rates, with infection as the most common cause for readmission.
HA is more frequently performed than PAO for hip dysplasia. HA-PAO is increasing at the greatest rate, demonstrating fewer complications and reoperations.
Level III, retrospective comparative trial.
分析髋关节镜检查（HA）和伯尔尼髋臼周围截骨术（PAO）治疗髋关节发育不良（HD）的年度使用情况以及术后结果，包括同侧再次手术情况。
使用[具体编码1]、[具体编码2]和[具体编码3]，从2010年1月至2022年1月查询PearlDiver Mariner数据库，以识别年龄在10至59岁之间、初步诊断为HD且随后接受以下治疗的患者：（1）HA；（2）PAO；或（3）HA与PAO联合治疗（HA-PAO，定义为在HA同一天或HA后28天内进行PAO）。我们分析了每种治疗的年度发生率以及术后急诊就诊率、再入院率和5年同侧二次手术率（通过Kaplan-Meier分析确定）。
共有32068例患者接受了HD的手术治疗。对于HA、PAO和HA-PAO，分别有29700例、2083例和285例患者。所有手术在2015年至2016年期间增幅最大。HA和HA-PAO在2021年达到峰值，而PAO在2019年达到峰值。对于HA、PAO和HA-PAO，大多数病例分别在女性患者以及年龄为30至49岁、10至19岁和10至29岁的患者中进行。HA组同侧二次手术（包括翻修HA、PAO或转换为全髋关节置换术）的5年发生率为9.2%（95%置信区间8.6%-9.8%），PAO组为6.5%（95%置信区间4.1%-8.8%）。HA与PAO联合治疗导致的二次手术极少，以至于无法进行Kaplan-Meier分析。PAO队列的30天急诊就诊率和90天再入院率最高，感染是再入院最常见的原因。
对于髋关节发育不良，HA的实施频率高于PAO。HA-PAO的增长速度最快，并发症和再次手术较少。
三级，回顾性比较试验。
