Effects of periacetabular osteotomy combined with hip arthroscopy in treating developmental dysplasia of the hip
10.3760/cma.j.cn121113-20210205-00130
- VernacularTitle:髋臼周围截骨术结合髋关节镜手术治疗成人发育性髋关节发育不良
- Author:
Zhefeng CHEN
1
;
Rui WANG
;
Jiuxiang LIU
;
Feng LIU
Author Information
1. 南京医科大学第一附属医院骨科 210009
- Keywords:
Osteotomy;
Hip Dislocation, Congenital;
Arthroscopy
- From:
Chinese Journal of Orthopaedics
2021;41(14):920-928
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of periacetabular osteotomy (PAO) combined with hip arthroscopy in treating adult developmental dysplasia of the hip (DDH).Methods:A total of sixty-one patients with DDH who received PAO surgery were enrolled in the present retrospective study. Of all patients, forty of them were treated by PAO combined with open arthrotomy from December 2015 to June 2018 as arthrotomy group. There were three males and 37 females in this group. Twenty-one DDH patients, including 2 males and 19 females, were treated by PAO combined with hip arthroscopy from July 2018 to June 2019 as arthroscopy group. The average ages were 31.08±11.24 and 33.25±11.70 years, respectively. Radiological parameters before and after surgery were compared between two groups. Modified Harris hip score (mHHS), nonarthritic hip score (NAHS), hip outcome score activity of daily living scale (HOS-ADL) at 6 months and 12 months postoperatively were compared between two groups.Results:The preoperative LCE (lateral center edge) angle, ACE (anterior center edge) angle, T?nnis angle, extrusion index in each group were 8.53°±9.09° vs. 9.15°±10.86°, 13.69°±12.43° vs. 7.18°±15.74°, 20.12°±6.24° vs. 22.13°±8.86° and 38.97%±7.55% vs. 37.64%±10.01% respectively. There was no statistical difference between two groups. Cam deformity (α angle >50°) existed in 17 patients (81%, 17/21) in arthroscopy group and in 31 patients (78%, 31/40) in arthrotomy group without significant difference between two groups (χ 2=0.096, P=0.756). At 12 months follow-up, all radiological parameters were improved from those before surgery. The LCE angle, ACE angle, T?nnis angle, extrusion index were 34.29°±5.07° vs. 32.76°±9.48°, 32.87°±4.23° vs. 30.26°±5.39°, -1.82°±5.88° vs. 2.16°±7.89° and 16.81%±4.53% vs. 18.20%±9.16% between groups without significant difference. The preoperative mHHS, NAHS, HOS-ADL in two groups were 60.38±12.19, 50.90±8.54, 72.23±11.86 and 60.00±13.53, 52.55±7.92, 72.70±12.18 respectively. At 12 months, there was no statistical difference in mHHS between the two groups (87.90±4.34 vs. 86.50±5.11, t=1.135, P=0.261). The NAHS and HOS-ADL in arthroscopy group were higher than those in arthrotomy group at 12 months follow-up (88.71±4.49 vs. 82.17±5.23, t=6.066, P<0.001; 90.33±2.71 vs. 87.12±3.33, t=3.800, P<0.001). Conclusion:During PAO in treating DDH, better short-term clinical results could be achieved when it combined with hip arthroscopy.
