髋关节镜和髋关节周围截骨术联合治疗髋关节发育不良的应用越来越多，且并发症发生率低

Q3 Medicine Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-06-01 DOI:10.1016/j.asmr.2024.100929

Juan Serna B.S., Kira Furie B.S., Stephanie E. Wong M.D., Ishaan Swarup M.D., Alan L. Zhang M.D., Mohammad Diab M.D.

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引用次数: 0

摘要

目的分析每年使用髋关节镜（HA）和伯尔尼髋臼周围截骨术（PAO）治疗髋关节发育不良（HD）的情况以及术后结果，包括同侧再手术。方法使用《国际疾病分类》第九版和第十版修订代码查询 PearlDiver Mariner 数据库（2010 年 1 月至 2022 年 1 月），以确定年龄在 10 岁至 59 岁之间、确诊为 HD 且随后接受了 (1) HA；(2) PAO；或 (3) HA 和 PAO 联合手术（HA-PAO，定义为 HA 后同一天或 28 天内进行 PAO）的患者。我们分析了每种治疗方法的年率以及术后急诊就诊率、再入院率和 5 年同侧二次手术率（通过 Kaplan-Meier 分析确定）。接受HA、PAO和HA-PAO手术的患者分别为29700人、2083人和285人。从2015年到2016年，所有手术的增幅最大。HA 和 HA-PAO 在 2021 年达到峰值，而 PAO 在 2019 年达到峰值。就HA、PAO和HA-PAO而言，大多数病例由女性患者实施，患者年龄分别为30至49岁、10至19岁和10至29岁。同侧二次手术（包括翻修HA、PAO或转为全髋关节置换术）的5年发生率在HA组为9.2%（95%置信区间为8.6%-9.8%），在PAO组为6.5%（95%置信区间为4.1%-8.8%）。将 HA 与 PAO 结合使用导致二次手术数量极少，因此无法进行 Kaplan-Meier 分析。PAO组的30天急诊就诊率和90天再入院率最高，感染是最常见的再入院原因。证据级别III级，回顾性比较试验。

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The Use of Combined Hip Arthroscopy and Periacetabular Osteotomy for Hip Dysplasia Is Increasing and Has Low Complication Rates

Purpose

To analyze the annual use of hip arthroscopy (HA) and Bernese periacetabular osteotomy (PAO) for the treatment of hip dysplasia (HD), as well as postoperative outcomes, including ipsilateral reoperations.

Methods

International Classification of Diseases, Ninth and Tenth Revision, codes were used to query the PearlDiver Mariner database from January 2010 through January 2022 to identify patients aged 10 to 59 years who had a presenting diagnosis of HD and subsequently underwent (1) HA; (2) PAO; or (3) combined HA and PAO (HA-PAO, defined as PAO on the same day or within 28 days after HA). We analyzed annual rates for each treatment, as well as rates of postoperative emergency visits, readmissions, and 5-year ipsilateral secondary operations (determined via Kaplan-Meier analysis).

Results

There were 32,068 patients who underwent surgical treatment of HD. For HA, PAO, and HA-PAO, there were 29,700, 2,083, and 285 patients, respectively. All operations had the greatest percent-increase from 2015 to 2016. HA and HA-PAO peaked in 2021, whereas PAO peaked in 2019. For HA, PAO, and HA-PAO, most cases were performed in female patients and patients aged 30 to 49 years, 10 to 19 years, and 10 to 29 years, respectively. The 5-year incidence of ipsilateral secondary operations, which include revision HA, PAO, or conversion to total hip arthroplasty, was 9.2% (95% confidence interval 8.6%-9.8%) in the HA group and 6.5% (95% confidence interval 4.1%-8.8%) in the PAO group. Combining HA with PAO resulted in so few secondary operations that Kaplan-Meier analysis was infeasible. The PAO cohort had the greatest 30-day emergency visit and 90-day readmission rates, with infection as the most common cause for readmission.

Conclusions

HA is more frequently performed than PAO for hip dysplasia. HA-PAO is increasing at the greatest rate, demonstrating fewer complications and reoperations.