Lee Jessica H, Girardi Nicholas G, Kraeutler Matthew J, Keeter Carson, Genuario James W, Garabekyan Tigran, Mei-Dan Omer
Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, U.S.A.
University of Colorado School of Medicine, Aurora, Colorado, U.S.A.
Arthroscopy. 2025 Jul;41(7):2351-2361. doi: 10.1016/j.arthro.2024.10.039. Epub 2024 Nov 7.
To determine staged hip arthroscopy and periacetabular osteotomy (PAO) mid-term outcomes in active patients aged 45 years and older compared with a younger group.
All patients aged 45 years and older who underwent staged arthroscopy and PAO between 2015 and 2021 were retrospectively analyzed and compared with a case-matched control group of younger patients. All patients underwent at least 6 months of nonoperative management prior to surgery. Prior to PAO, all patients underwent hip arthroscopy to address any intra-articular pathology. The experimental group consisted of patients with dysplasia aged 45 years and older without significant osteoarthritis who underwent PAO and reported patient-reported outcomes for a minimum of 1 year postoperatively. Patient-reported outcomes were quantified using the International Hip Outcome Tool 12 (iHOT-12) score and Non-arthritic Hip Score (NAHS).
The cohort consisted of 35 patients (44 hips) with a mean age of 49.4 ± 3.8 years. The lateral center-edge angle significantly improved from preoperatively (20.1° ± 4.5°) to postoperatively (33.2° ± 3.2°, P < .001). The mean follow-up period in the PAO cohort aged 45 years and older was 2.80 years (standard deviation, 1.3 years) postoperatively. Patients reported significant improvements in the iHOT-12 score (36.6 ± 14.1 preoperatively vs 81.2 ± 21.0 at latest follow-up, P < .001) and NAHS (59.2 ± 15.5 preoperatively vs 87.4 ± 13.1 at latest follow-up, P < .001). The older cohort did not report significantly different iHOT-12 scores compared with the control group at any point, and age did not significantly affect either outcome score (P > .05).
Patients aged 45 years and older reported a statistically significant improvement in hip function and pain after staged hip arthroscopy and PAO, with outcome scores comparable to a younger cohort. Our findings show that appropriately selected older patients with dysplasia without significant pre-existing hip osteoarthritis experience clinically meaningful improvements in hip pain and function after hip preservation surgery.
Level III, retrospective, comparative case series.
确定45岁及以上活跃患者与较年轻组相比，分期髋关节镜检查和髋臼周围截骨术（PAO）的中期疗效。
对2015年至2021年间接受分期关节镜检查和PAO的所有45岁及以上患者进行回顾性分析，并与年龄匹配的较年轻患者对照组进行比较。所有患者在手术前均接受了至少6个月的非手术治疗。在进行PAO之前，所有患者均接受髋关节镜检查以处理任何关节内病变。实验组由45岁及以上、无明显骨关节炎的发育不良患者组成，这些患者接受了PAO，并在术后至少1年报告了患者报告的结局。使用国际髋关节结局工具12（iHOT-12）评分和非关节炎髋关节评分（NAHS）对患者报告的结局进行量化。
该队列包括35例患者（44髋），平均年龄为49.4±3.8岁。外侧中心边缘角从术前（20.1°±4.5°）显著改善至术后（33.2°±3.2°，P<.001）。45岁及以上PAO队列术后平均随访期为2.80年（标准差，1.3年）。患者报告iHOT-12评分（术前36.6±14.1，最近随访时为81.2±21.0，P<.001）和NAHS（术前59.2±15.5，最近随访时为87.4±13.1，P<.001）有显著改善。在任何时间点，较年长队列与对照组相比，iHOT-12评分均无显著差异，年龄对任何一项结局评分均无显著影响（P>.05）。
45岁及以上患者在分期髋关节镜检查和PAO后，髋关节功能和疼痛有统计学意义的改善，结局评分与较年轻队列相当。我们的研究结果表明，适当选择的、无明显既往髋关节骨关节炎的发育不良老年患者，在保髋手术后髋关节疼痛和功能有临床意义的改善。
III级，回顾性、比较病例系列。
