Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, Kingdom of Saudi Arabia.
Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, Illinois, USA.
Scand J Med Sci Sports. 2024 Aug;34(8):e14711. doi: 10.1111/sms.14711.
Individuals with acetabular dysplasia often report hip joint instability, pain, and poor hip-related function. Periacetabular osteotomy (PAO) is a surgical procedure that aims to reposition the acetabulum to improve joint congruency and improve pain and function. We aimed to examine the influence of presurgery clinical measures on functional recovery following PAO and the associations among clinical outcomes after PAO.
We screened 49 potential participants, 28 were enrolled, and 23 completed both study visits (pre-PAO and 6 months post-PAO). We evaluated dynamometer-measured hip and thigh strength, loading patterns during a squat and countermovement jump (CMJ), pain intensity, and device-measured physical activity (PA) levels (light, moderate-to-vigorous PA [MVPA], and daily steps). We used linear regression models to examine the influence of muscle strength (peak torque; limb symmetry index [LSI]) and loading patterns before PAO on pain intensity and PA levels in individuals 6 months following PAO. Additionally, we used Pearson correlation coefficient to examine cross-sectional associations among all variables 6 months following PAO.
Lower extremity muscle strength and loading patterns during the squat and CMJ before PAO did not predict pain intensity or device-measured PA levels in individuals 6 months following PAO (p > 0.05). Six months following PAO, higher knee extensor LSI was associated with higher time spent in MVPA (r = 0.56; p = 0.016), higher hip abductor LSI was associated with both lower pain (r = 0.50; p = 0.036) and higher involved limb loading during the squat task (r = 0.59; p = 0.010). Lastly, higher hip flexor LSI was associated with higher CMJ takeoff involved limb loading (r = 0.52; p = 0.021) and higher involved hip extensor strength was associated with higher CMJ landing involved limb loading (r = 0.56; p = 0.012).
Six months after PAO, higher hip and thigh muscle strength and strength symmetry were associated with lower pain, higher PA levels, and greater normalized limb loading during dynamic movement tasks.
髋臼发育不良患者常报告髋关节不稳定、疼痛和髋关节功能不良。髋臼周围截骨术（PAO）是一种旨在重新定位髋臼以改善关节吻合度并改善疼痛和功能的手术。我们旨在研究术前临床指标对 PAO 后功能恢复的影响以及 PAO 后临床结果之间的关联。
我们筛选了 49 名潜在参与者，其中 28 名入选，23 名完成了术前和 6 个月后的 PAO 研究访视。我们评估了测力器测量的髋关节和大腿力量、深蹲和反向跳（CMJ）过程中的负荷模式、疼痛强度以及设备测量的体力活动（PA）水平（轻度、中高强度 PA[MVPA]和每日步数）。我们使用线性回归模型来研究 PAO 前肌肉力量（峰值扭矩；肢体对称指数[LSI]）和负荷模式对 PAO 后 6 个月个体疼痛强度和 PA 水平的影响。此外，我们使用 Pearson 相关系数来研究 PAO 后 6 个月所有变量之间的横断面关联。
PAO 前下肢肌肉力量和深蹲及 CMJ 过程中的负荷模式不能预测 PAO 后 6 个月个体的疼痛强度或设备测量的 PA 水平（p>0.05）。PAO 后 6 个月，较高的膝关节伸肌 LSI 与 MVPA 时间较长相关（r=0.56；p=0.016），较高的髋关节外展肌 LSI 与较低的疼痛（r=0.50；p=0.036）和深蹲任务中受影响肢体的负荷增加相关（r=0.59；p=0.010）。最后，较高的髋关节屈肌 LSI 与 CMJ 起跳时受影响肢体的负荷增加相关（r=0.52；p=0.021），较高的髋关节伸肌 LSI 与 CMJ 落地时受影响肢体的负荷增加相关（r=0.56；p=0.012）。
PAO 后 6 个月，较高的髋关节和大腿肌肉力量和力量对称性与较低的疼痛、较高的 PA 水平以及动态运动任务中更大的正常化肢体负荷相关。
