Frischholz Sebastian, Heinz Tizian, Weißenberger Manuel, von Hertzberg-Boelch Sebastian Philipp, Anderson Philip, Lüdemann Martin, Jakuscheit Axel, Rudert Maximilian, Stratos Ioannis
Department of Orthopaedic Surgery, University of Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, 97074 Wuerzburg, Germany.
Life (Basel). 2024 Oct 3;14(10):1262. doi: 10.3390/life14101262.
Cartilage repair techniques for chondral defects in the hip are crucial for treating conditions like femoroacetabular impingement, developmental dysplasia, and osteonecrosis, especially in young patients to delay the progression of osteoarthritis. This study aims to present age and sex distributions and trends in hip-preserving surgeries in Germany from 2006 to 2022, analyzing 116,179 procedures using the German OPS coding system. The procedures were categorized into three groups: debridement, refixation, and regeneration. Arthroscopy was more common than arthrotomy (98,916 vs. 17,263). Males underwent more procedures than females (63,771 vs. 52,408). Debridement had a monomodal age distribution peaking at 43.42 years, while refixation and regeneration exhibited bimodal patterns. Regenerative procedures were primarily performed on younger patients (average 27.73 years). A Joinpoint analysis showed an initial increase in procedures, peaking around 2013, followed by a decline. Arthroscopic procedures peaked at approximately 9000 in 2013, whereas arthrotomies peaked at around 1200 after 2014. The decline in procedures post-2013 may reflect refined surgical indications and a shift towards outpatient settings. These findings underscore the trend towards minimally invasive, scaffold-based treatments, with regenerative techniques showing promising outcomes in younger patients. Future research should focus on prospective comparative studies and cost-benefit analyses to guide clinical decision-making.
髋关节软骨损伤的软骨修复技术对于治疗股骨髋臼撞击症、发育性髋关节发育不良和骨坏死等疾病至关重要，特别是对于年轻患者，可延缓骨关节炎的进展。本研究旨在呈现2006年至2022年德国保髋手术的年龄和性别分布及趋势，使用德国手术操作分类（OPS）编码系统分析116,179例手术。这些手术分为三组：清创术、固定修复术和再生术。关节镜检查比切开手术更常见（98,916例对17,263例）。男性接受的手术比女性多（63,771例对52,408例）。清创术的年龄分布呈单峰型，在43.42岁达到峰值，而固定修复术和再生术则呈现双峰模式。再生手术主要针对年轻患者（平均27.73岁）。连接点分析显示手术数量最初增加，在2013年左右达到峰值，随后下降。关节镜手术在2013年达到约9000例的峰值，而切开手术在2014年后达到约1200例的峰值。2013年后手术数量的下降可能反映了手术适应症的细化和向门诊治疗的转变。这些发现强调了向微创、基于支架的治疗方法发展的趋势，再生技术在年轻患者中显示出有前景的结果。未来的研究应侧重于前瞻性比较研究和成本效益分析，以指导临床决策。
