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髋臼周围截骨术后早期并发症:一项对1356例连续手术的单中心队列研究。

Early postoperative complications following periacetabular osteotomy: a single-center cohort study on 1,356 consecutive procedures.

作者信息

Kristiansen Anne R, Ovesen Ole, Haubro Martin H, Holsgaard-Larsen Anders, Overgaard Søren, Lindberg-Larsen Martin

机构信息

Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Denmark.

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark.

出版信息

Acta Orthop. 2025 Aug 7;96:595-600. doi: 10.2340/17453674.2025.44402.

Abstract

BACKGROUND AND PURPOSE

Periacetabular osteotomy (PAO) is a major surgical procedure, yet data on early postoperative complications and hospitalizations remains limited. We aimed to report postoperative complications within 90 days using the modified Clavien-Dindo classification system. Our secondary aim was to report the peri- and postoperative complications observed in patients with length of hospital stay (LOS) exceeding 4 days or readmitted within 90 days following PAO.

METHODS

We identified patients who underwent PAO at a single institution between 2006 and 2021. Patient characteristics, LOS, in-hospital complications, and readmissions within 90 days postoperatively were obtained from our institutional database, patient files, and the Danish National Patient Registry to ensure complete follow up. Minor complications were defined as Clavien-Dindo grades 1 and 2, while major complications were defined as grades 3 and 4.

RESULTS

1,356 consecutive PAO procedures were performed in 1,096 patients with a mean age of 29.3 years (SD 11.1) and 77% females. Minor complications occurred in 499 hips (37%, 95% confidence interval [CI] 35-39) within 90 days of PAO. Only 16 (1.2%, CI 0.6-1.8) major complications were observed. LOS exceeded 4 days in 244 cases (18%) most frequently linked with nausea and emesis in 40 (2.9%). The 90-day readmission rate was 4.4% (CI 2.6-6.2), most commonly linked with pain in 11 (1.0%) and wound infection requiring antibiotics also in 11 (1.0%).

CONCLUSION

PAO was associated with 37% minor complications within 90 days, while major complications were rare, occurring in only 1.2% of cases. After 18% of PAO procedures, LOS exceeded 4 days, and the 90-day readmission rate was 4.4%.

摘要

背景与目的

髋臼周围截骨术(PAO)是一项大型外科手术,但关于术后早期并发症和住院情况的数据仍然有限。我们旨在使用改良的Clavien-Dindo分类系统报告90天内的术后并发症。我们的次要目的是报告PAO术后住院时间(LOS)超过4天或90天内再次入院患者的围手术期和术后并发症。

方法

我们确定了2006年至2021年间在单一机构接受PAO的患者。从我们的机构数据库、患者病历和丹麦国家患者登记处获取患者特征、LOS、院内并发症和术后90天内的再次入院情况,以确保完整的随访。轻微并发症定义为Clavien-Dindo 1级和2级,而严重并发症定义为3级和4级。

结果

1096例患者共进行了1356例连续PAO手术,平均年龄29.3岁(标准差11.1),女性占77%。499髋(37%,95%置信区间[CI] 35 - 39)在PAO后90天内出现轻微并发症。仅观察到16例(1.2%,CI 0.6 - 1.8)严重并发症。244例(18%)LOS超过4天,最常见的是40例(2.9%)出现恶心和呕吐。90天再入院率为4.4%(CI 2.6 - 6.2),最常见的是11例(1.0%)与疼痛有关,11例(1.0%)与需要使用抗生素的伤口感染有关。

结论

PAO术后90天内37%出现轻微并发症,而严重并发症罕见,仅1.2%的病例发生。18%的PAO手术后,LOS超过4天,90天再入院率为4.4%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aca/12337780/55f4e871cb9a/ActaO-96-44402-g001.jpg

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