Acetabular rim syndrome revisited.

IF 4.9 1区医学 Q1 ORTHOPEDICS Bone & Joint Journal Pub Date : 2024-12-01 DOI:10.1302/0301-620X.106B12.BJJ-2024-0164.R1

William Z Morris, Shamrez Haider, Sean T Hinds, David Podeszwa, Henry Ellis, Lauren Osborne, Nicholas Anable, Daniel Sucato

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Abstract

Aims: There has been limited literature regarding outcomes of acetabular rim syndrome (ARS) with persistent acetabular os in the setting of acetabular dysplasia. The purpose of this study was to characterize a cohort of adolescent and young adult patients with ARS with persistent os and compare their radiological and clinical outcomes to patients with acetabular dysplasia without an os.

Methods: We reviewed a prospective database of patients undergoing periacetabular osteotomy (PAO) for symptomatic acetabular dysplasia between January 1999 and December 2021 to identify hips with preoperative os acetabuli, defined as a closed triradiate cartilage but persistence of a superolateral os acetabulum. A total of 14 hips in 12 patients with persistent os acetabuli (ARS cohort) were compared to 50 randomly selected 'control' hips without persistent os acetabuli. Preoperative and postoperative radiographs were measured for markers of dysplasia: lateral centre-edge angle, anterior centre-edge angle, acetabular inclination, and migration index. Union of the os was determined in patients with ≥ six months' follow-up. Patient-reported outcome measures (PROMs) included the University of California, Los Angeles (UCLA) activity score and modified Harris Hip Score (mHHS, maximum score 80) completed at one year postoperatively.

Results: There was no significant difference between the ARS and control cohorts with regard to sex distribution (p = 0.270), age at surgery (p = 0.186), or BMI (p = 0.442). Preoperatively, the ARS cohort had more severe dysplasia, including lower lateral centre-edge angle (-9.3° (SD 12.5°) vs 7.6° (SD 10.7°); p < 0.001) and greater acetabular inclination (33.9° (SD 8.2°) vs 21.8° (SD 8.7°); p < 0.001). Postoperatively, 6/13 (46%) hips with ≥ six months of radiological follow up demonstrated union of the os. There was no difference between the ARS and control cohorts at one year in UCLA score (9.1 (SD 1.5) vs 8.2 (SD 1.9); p = 0.167) or mHHS (73.4 (SD 9.5) vs 69.9 (SD 8.8); p = 0.312).

Conclusion: ARS with persistent acetabular os may occur in more severe dysplasia. Union occurs in 50% cases following corrective PAO.

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髋臼缘综合征复发。

目的：关于髋臼发育不良伴持续性髋臼骨缺失的髋臼缘综合征（ARS）的预后文献有限。本研究的目的是描述一组伴有持续性骨缺损的青少年和年轻成人ARS患者，并将其放射学和临床结果与无骨缺损的髋臼发育不良患者进行比较。方法：我们回顾了1999年1月至2021年12月期间因症状性髋臼发育不良而接受髋臼周围截骨术（PAO）患者的前瞻性数据库，以确定术前髋臼骨缺失的髋关节，髋臼骨缺失定义为闭合的三放射软骨，但髋臼上外侧持续存在。12例持续性髋臼不全患者共14髋（ARS队列）与50例随机选择的无持续性髋臼不全的“对照”髋进行比较。术前和术后x线片测量发育不良的标志物：外侧中心棱角、前中心棱角、髋臼倾斜度和移位指数。在随访≥6个月的患者中确定os的联合。患者报告的结果测量（PROMs）包括术后一年完成的加州大学洛杉矶分校（UCLA）活动评分和改良Harris髋关节评分（mHHS，最高评分80）。结果：ARS组和对照组在性别分布（p = 0.270）、手术年龄（p = 0.186）和BMI （p = 0.442）方面无显著差异。术前，ARS队列有更严重的发育不良，包括较低的外侧中心边缘角(-9.3°（SD 12.5°）vs 7.6°（SD 10.7°）；p < 0.001)和更大的髋臼倾斜(33.9°（SD 8.2°）vs 21.8°（SD 8.7°）；P < 0.001)。术后，6/13（46%）髋经≥6个月的放射随访证实骨关节愈合。ARS组和对照组一年时UCLA评分无差异(9.1 (SD 1.5) vs 8.2 (SD 1.9)；p = 0.167)或mHHS (73.4 (SD 9.5) vs 69.9 (SD 8.8)；P = 0.312)。结论：伴有持续髋臼骨的ARS可发生在更严重的发育不良中。矫正性PAO术后愈合率为50%。

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

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