伯尔尼髋臼周围截骨术后骨盆倾斜-一项长期随访研究

IF 1.4 4区 医学 Q3 ORTHOPEDICS Journal of Hip Preservation Surgery Pub Date : 2023-09-09 DOI:10.1093/jhps/hnad030
Alexander F Heimann, Iris F Brouze, Guoyan Zheng, Angela M Moosmann, Joseph M Schwab, Moritz Tannast, Corinne A Zurmühle
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引用次数: 0

摘要

发育性髋关节发育不良(DDH)患者被认为表现为骨盆前倾斜增加,以补偿股骨头前覆盖范围的减少。如果是这样,发育不良患者的骨盆倾斜度在术前应该很高,在髋臼周围截骨(PAO)矫正后应该降低。迄今为止,PAO术后长期随访中骨盆倾斜的演变尚未见报道。因此,我们提出了以下问题:(i) DDH患者和无症状对照组之间骨盆倾斜是否存在差异?(ii)与术前相比,伯尔尼PAO术后长期随访期间骨盆倾斜的变化情况如何?本研究为治疗性研究,证据等级为III级。我们回顾性比较了64例(71髋)发育不良患者术前骨盆倾斜与20例(20髋)无症状对照组。此外,对术后即刻和长期随访(18±8[范围7-34年)骨盆倾斜进行评估和比较。发育不良患者术前骨盆倾斜的平均值明显高于对照组[2.3±5.3°(- 11.2°至16.4°)vs 1.1±3.0°(- 4.9至5.9),P = 0.006]。术后平均骨盆倾斜为1.5±5.3°(- 11.2 ~ 17.0°,P = 0.221),长期随访为0.4±5.7°(- 9.9 ~ 20.9°,P = 0.002)。在长期随访中,接受PAO治疗的髋发育不良患者骨盆倾斜有统计学意义的降低。然而,由于骨盆倾斜的个体间差异很大,观察到的差异可能没有临床意义。
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Pelvic tilt after Bernese periacetabular osteotomy—a long-term follow-up study
ABSTRACT Patients with developmental dysplasia of the hip (DDH) are believed to present with increased anterior pelvic tilt to compensate for reduced anterior femoral head coverage. If true, pelvic tilt in dysplastic patients should be high preoperatively and decrease after correction with periacetabular osteotomy (PAO). To date, the evolution of pelvic tilt in long-term follow-up after PAO has not been reported. We therefore asked the following questions: (i) is there a difference in pelvic tilt between patients with DDH and an asymptomatic control group? (ii) How does pelvic tilt evolve during long-term follow-up after Bernese PAO compared with before surgery? This study is a therapeutic study with the level of evidence III. We retrospectively compared preoperative pelvic tilt in 64 dysplastic patients (71 hips) with an asymptomatic control group of 20 patients (20 hips). In addition, immediate postoperative and long-term follow-up (at 18 ± 8 [range 7–34 years) pelvic tilt was assessed and compared. Dysplastic patients had a significantly higher mean preoperative pelvic tilt than controls [2.3 ± 5.3° (−11.2° to 16.4°) versus 1.1 ± 3.0° (−4.9 to 5.9), P = 0.006]. Mean pelvic tilt postoperatively was 1.5 ± 5.3° (−11.2 to 17.0º, P = 0.221) and at long-term follow-up was 0.4 ± 5.7° (range −9.9° to 20.9°, P = 0.002). Dysplastic hips undergoing PAO show a statistically significant decrease in pelvic tilt during long-term follow-up. However, given the large interindividual variability in pelvic tilt, the observed differences may not achieve clinical significance.
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Levels of evidence. What the papers say. A growing role for Registry data to guide discussions with patients on their treatment options. What The Papers Say. Clinical and surgical factors influencing screw breakage during hardware removal following periacetabular osteotomy.
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