三截骨术可显著改善髋关节发育不良患者的生活质量

IF 2.7 Q2 ORTHOPEDICS Journal of Experimental Orthopaedics Pub Date : 2025-03-07 DOI:10.1002/jeo2.70208

Julia Elisabeth Lenz, Moritz Riedl, Dominik Szymski, Stefan Landgraeber, Volker Alt, Stefan Fickert

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引用次数: 0

摘要

目的三截骨术（three- osteotomy， TO）是一种保留髋关节的手术技术，旨在通过实现髋臼三维复位和改善股骨头覆盖范围来纠正有症状的髋关节发育不良。该手术在减轻疼痛、功能恢复和生活质量方面显示出良好的效果，特别是在年轻、活跃的患者中。虽然髋臼周围截骨术（PAO）是另一种公认的髋关节保存方法，但TO的具体优势，特别是在早期恢复和患者报告的结果（PROMs）方面，仍未得到充分探讨。本研究使用iHOT33工具评估TO的中期结果，以提供对其临床益处的全面了解。方法：在德国软骨登记中心进行的这项非随机、回顾性登记研究包括48例有症状的、放射学证实的髋关节发育不良患者，这些患者由同一位专家接受了TO治疗。24个月随访率为60.4%，平均随访时间为24个月。测量的结果包括iHOT33评分、生活质量、疼痛VAS评分、满意度、感知治疗收益和失业率。采用配对t检验和回归分析（p < 0.05）。结果术前iHOT33评分平均46.9分，24个月后提高到70.8分（Δ 23.9），前6个月有明显改善（Δ 15.8）。“社交”子领域表现出最大的改善（Δ 30分），以及生活质量和疼痛减轻（VAS）的改善。术后角度（VCE 31°±4°，髋臼指数0°±3°）在正常范围内。角度变化与iHOT33评分之间没有明显的相关性，表明在发育不良严重程度上都有益处。结论：通过iHOT33和其他主观评估，三段式截骨术显著且快速地改善了髋关节发育不良患者报告的预后，特别是在提高社会和运动相关的生活质量方面。它相对于髋臼周围截骨术的潜在优势，特别是在早期恢复方面，值得通过前瞻性比较研究进一步研究，以更好地确定其在保髋手术策略中的作用。证据等级三级。

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Triple-Osteotomy leads to substantially improved quality of life in patients with hip dysplasia

Purpose

Triple-Osteotomy (TO) is a hip-preserving surgical technique designed to correct symptomatic hip dysplasia by achieving three-dimensional acetabular reorientation and improving femoral head coverage. This procedure has shown promising outcomes in pain reduction, functional recovery, and quality of life, particularly in young, active patients. While periacetabular-osteotomy (PAO) is another well-established method for hip preservation, the specific advantages of TO, especially in early recovery and patient-reported outcomes (PROMs), remain underexplored. This study evaluates the mid-term outcomes of TO using the iHOT33 tool to provide a comprehensive understanding of its clinical benefits.

Methods

This non-randomised, retrospective registry study within the German Cartilage Registry included 48 patients with symptomatic, radiologically confirmed hip dysplasia who underwent TO by the same specialist. The follow-up rate at 24 months was 60.4% with a mean follow-up time of 24 months. Outcomes measured included iHOT33 scores, quality of life, VAS for pain, satisfaction, perceived treatment benefit, and unemployment rate. Paired t-tests and regression analysis (p < 0.05) were applied.

Results

Preoperative iHOT33 scores averaged 46.9, increasing to 70.8 after 24 months (Δ 23.9), with notable improvement in the first 6 months (Δ 15.8). The “social” subdomain showed the greatest improvements (Δ 30 points), alongside improvements in quality of life and pain reduction (VAS). Postoperative angles (VCE 31° ± 4°, acetabular index 0° ± 3°) were within the normal range. No significant correlation was found between angle changes and iHOT33 scores, indicating benefits across dysplasia severities.

Conclusions

Triple-osteotomy offers significant and rapid improvements in patient-reported outcomes for individuals with hip dysplasia, particularly in enhancing social and sports-related quality of life as measured by iHOT33 and other subjective assessments. Its potential advantages over Periacetabular-osteotomy, especially in terms of early recovery, warrant further investigation through prospective, comparative studies to better define its role in hip-preserving surgical strategies.