Holleyman Richard James, Smith Christian, Baig Khurram, Bankes Marcus, Witt Johan, Judge Andy, Khanduja Vikas, Malviya Ajay
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England, UK.
Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster, UK.
Orthop J Sports Med. 2025 Jun 25;13(6):23259671251341475. doi: 10.1177/23259671251341475. eCollection 2025 Jun.
Periacetabular osteotomy (PAO) is an established treatment for symptomatic developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI; principally acetabular retroversion) in adults who are commonly of reproductive age.
To describe the effect of PAO on patient-reported sexual function (SF) using data from the UK Non-Arthroplasty Hip Registry (NAHR).
Cohort study: Level of evidence, 3.
Adult patients who underwent isolated PAO between January 2012 and July 2022 were extracted from the NAHR. The EuroQol-5 Dimensions (EQ-5D) and International Hip Outcome Tool 12 (iHOT-12) questionnaires were collected preoperatively and at 6 and 12 months postoperatively. This included responses to 2 questions from the iHOT-12 questionnaire relevant to SF: (1) "Are questions about SF relevant to you?" and (2) "How much trouble do you have with sexual activity because of your hip?" (0 = severe; 100 = none).
A total of 773 patients (median age, 29 years (IQR, 23-37), 92.5% female) who underwent PAO for DDH (n = 703; 90.9%) or FAI (n = 70; 9.1%) were identified after exclusions. Of iHOT-12 respondents, 88.2% indicated that SF was relevant to them. Baseline median iHOT-12 SF scores were 33 (IQR, 18-53) for female and 73 (IQR, 36-90) for male patients. Female iHOT-12 SF improved by a mean of +19.9 points (95% CI, 16.5-23.2) at 6 months ( < .0001), with continued improvement to +26.4 points (95% CI, 23.0-29.8) at 12 months ( < .0001) versus preoperative SF scores. At 12 months, median iHOT-12 SF scores were 70 (IQR, 40-90) and 89 (IQR, 70-99) for female and male patients, respectively. Preoperative SF scores were significantly lower ( = .001) in patients who underwent PAO for indication of FAI (female median score 22; IQR, 10-38) compared with DDH (female median score: 34; IQR, 18-54); however, both indications saw significant improvement in SF scores at 12 months. iHOT-12 SF scores improved for 77.1% and worsened for 19.1% of female respondents with DDH. A strong positive association was seen between health-related quality of life (EQ-5D) and SF scores, and there was significant improvement in SF across studied ages.
PAO was associated with significant improvement in patient-reported SF for the majority of patients. Some patients may have trouble with sexual activity even 1 year after PAO for DDH, with almost 20% reporting poorer SF compared with preoperative baseline.
髋臼周围截骨术（PAO）是治疗有症状的发育性髋关节发育不良（DDH）以及成年患者（通常为育龄期）股骨髋臼撞击症（FAI，主要是髋臼后倾）的一种既定疗法。
利用英国非关节置换髋关节注册中心（NAHR）的数据，描述PAO对患者报告的性功能（SF）的影响。
队列研究；证据等级：3级。
从NAHR中提取2012年1月至2022年7月期间接受单纯PAO手术的成年患者。术前以及术后6个月和12个月收集欧洲五维健康量表（EQ-5D）和国际髋关节疗效工具12（iHOT-12）问卷。这包括对iHOT-12问卷中与SF相关的2个问题的回答：（1）“与SF相关的问题和您有关吗？”以及（2）“您的髋关节给您的性活动带来了多大困扰？”（0 = 严重；100 = 无）。
排除后，共确定773例接受PAO治疗DDH（n = 703；90.9%）或FAI（n = 70；9.1%）的患者（中位年龄29岁（四分位间距，23 - 37岁），92.5%为女性）。在iHOT-12问卷的受访者中，88.2%表示SF与他们相关。女性患者术前iHOT-12 SF中位评分为33（四分位间距，18 - 53），男性患者为73（四分位间距，36 - 90）。女性iHOT-12 SF在术后6个月平均提高了19.9分（95%可信区间，16.5 - 23.2）（P <.0001），到术后12个月持续提高至26.4分（95%可信区间，23.0 - 29.8）（P <.0001），与术前SF评分相比。在术后12个月，女性和男性患者的iHOT-12 SF中位评分分别为70（四分位间距，40 - 90）和89（四分位间距，70 - 99）。因FAI接受PAO治疗的患者术前SF评分显著更低（P = 0.001）（女性中位评分为22；四分位间距，10 - 38），而DDH患者（女性中位评分为34；四分位间距，18 - 54）；然而，两种指征的患者在术后12个月时SF评分均有显著改善。DDH女性受访者中，77.1%的iHOT-12 SF评分有所改善，19.1%的评分变差。健康相关生活质量（EQ-5D）与SF评分之间存在强正相关，且各研究年龄组的SF均有显著改善。
对于大多数患者而言，PAO与患者报告的SF显著改善相关。一些患者即使在因DDH接受PAO治疗1年后仍可能在性活动方面存在困扰，近20%的患者报告与术前基线相比SF更差。
