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髋臼周围截骨术对Crowe I型髋关节发育不良软骨改善的影响:短期分析

Impact of Periacetabular Osteotomy on Cartilage Enhancement in Crowe Group I Hip Dysplasia: A Short-Term Analysis.

作者信息

Xu Meng, Zhu Chenyi, Di Zexin, Zhong Lei

机构信息

Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China.

Department of Orthopedics, Luoyang Orthopedic-Traumatological Hospital of Henan Province, Luoyang, Henan, China.

出版信息

Med Sci Monit. 2025 May 23;31:e946764. doi: 10.12659/MSM.946764.

Abstract

BACKGROUND Developmental dysplasia of the hip (DDH; congenital dislocation of the hip, or hip dysplasia) in infants and children occurs when the joint does not properly form. The group 1 Crowe classification of DDH includes <50% subluxation. This study aimed to evaluate 26 hips in 16 adolescents and young adults aged 13-35 years with Crowe group I DDH who underwent periacetabular osteotomy, with a mean follow-up of 4.5 years. MATERIAL AND METHODS Sixteen patients (26 hips; age 13-35 years) with Crowe group I DDH underwent PAO from 2015 to 2019, with a mean follow-up of 4.5 years. Evaluations included clinical indices (Harris hip score, visual analog scale [VAS] pain scores), radiographic parameters (center-edge angle, vertical-center-anterior angle, acetabular index, Sharp angle, Shenton line continuity, acetabular sourcil length), CT angles (horizontal acetabular-sector angle [HASA], anterior acetabular-sector angle [AASA], posterior acetabular-sector angle [PASA]), and MRI measurements of acetabular cartilage length and area. RESULTS Postoperative Harris hip scores significantly improved (71.65±5.42 to 87.12±4.47, P<0.05), and VAS pain scores significantly decreased (5.12±1.33 to 2.24±0.77, P<0.05). Radiographic parameters (center-edge angle, vertical-center-anterior angle, acetabular index, Shenton line continuity), CT angles (HASA, PASA, AASA), and MRI measurements of cartilage length (25.32±8.11 mm to 29.81±8.14 mm, P<0.05) and area (613.73±119.37 mm² to 710.02±117.17 mm², P<0.01) significantly improved. CONCLUSIONS Periacetabular osteotomy significantly improved short-term clinical outcomes, acetabular coverage, and cartilage morphology in the weight-bearing region in patients with Crowe group I DDH. The observed increases in acetabular sourcil length and cartilage dimensions suggest biomechanical improvements, potentially delaying osteoarthritis progression.

摘要

背景

婴幼儿和儿童的发育性髋关节发育不良(DDH;先天性髋关节脱位或髋关节发育异常)是指关节未正常形成。DDH的1型Crowe分类包括半脱位小于50%。本研究旨在评估16例年龄在13 - 35岁的青少年和年轻成人中26个患1型Crowe DDH且接受了髋臼周围截骨术的髋关节,平均随访4.5年。

材料与方法

16例(26个髋关节;年龄13 - 35岁)1型Crowe DDH患者于2015年至2019年接受了髋臼周围截骨术,平均随访4.5年。评估包括临床指标(Harris髋关节评分、视觉模拟量表[VAS]疼痛评分)、影像学参数(中心边缘角、垂直中心前角、髋臼指数、Sharp角、Shenton线连续性、髋臼眉长度)、CT角度(水平髋臼扇形角[HASA]、前髋臼扇形角[AASA]、后髋臼扇形角[PASA])以及髋臼软骨长度和面积的MRI测量。

结果

术后Harris髋关节评分显著改善(从71.65±5.42提高到87.12±4.47,P<0.05),VAS疼痛评分显著降低(从5.12±1.33降至2.24±0.77,P<0.05)。影像学参数(中心边缘角、垂直中心前角、髋臼指数、Shenton线连续性)、CT角度(HASA、PASA、AASA)以及软骨长度的MRI测量值(从25.32±8.11mm提高到29.81±8.14mm,P<0.05)和面积(从613.73±119.37mm²提高到710.02±117.17mm²,P<0.01)均显著改善。

结论

髋臼周围截骨术显著改善了1型Crowe DDH患者的短期临床结局、髋臼覆盖以及负重区的软骨形态。观察到的髋臼眉长度和软骨尺寸增加提示生物力学改善,可能会延缓骨关节炎的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/333d/12108145/947203743714/medscimonit-31-e946764-g001.jpg

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