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作者

顾言阁 石志伟 段续东 殷鲁旭 张业勇 孙华强 李树锋 闫新峰

作者单位

山东大学齐鲁医学院 山东第一医科大学第一附属医院（山东省千佛山医院）骨外科，山东省风湿免疫病转化医学重点实验室 西安交通大学医学部

刊名

中华关节外科杂志(电子版)

年份

2022

卷号

第16卷

期号

第1期

页码

8-15

ISSN

1674-134X

关键词

髋脱位，先天性 骨疾病，发育性 截骨术

摘要

Objective:To explore the influencing factors of postoperative functional recovery of Bernese periacetabular osteotomy and influencing factors of pain degree.Methods:A retrospective study was conducted on the patients with developmental dysplasia of the hip who underwent Bernese periacetabular osteotomy with a modified Smith-Peterson approach between January 2017 and November 2019. The inclusion criteria was all the DDH patients who received PAO during this period. Exclusion criteria: history of...更多

Objective:To explore the influencing factors of postoperative functional recovery of Bernese periacetabular osteotomy and influencing factors of pain degree.Methods:A retrospective study was conducted on the patients with developmental dysplasia of the hip who underwent Bernese periacetabular osteotomy with a modified Smith-Peterson approach between January 2017 and November 2019. The inclusion criteria was all the DDH patients who received PAO during this period. Exclusion criteria: history of hip joint trauma, existing diseases of nerve, muscle or connective tissue, history of hip surgery, incomplete image data, acetabular retroversion , the iliac-inguinal approach patients, and the patients who were lost during the follow-up. The preoperative and postoperative imaging indicators were measured. The acetabular top tilt angle, lateral central edge angle, acetabular abduction angle, femoral head extrusion index, sphericity index of femoral head, Shenton line, Tonnis grade of osteoarthritis, joint congruency, p/a ratio, acetabular anteversion angle, Western Ontario and McMaster Universities osteoarthritis index pain score and modified Harris hip score were measured and recorded. Multiple regression analysis was applied to determine the preoperative pain degree and postoperative function influencing factors.Results:A total of 75 patients underwent Bernese PAO. Among them, 16 cases using the iliac-inguinal approach were excluded, five cases were lost during follow-up, eight cases had incomplete imaging data, and there were two cases of acetabular retroversion. Eventually the study was conducted on 44 patients. The follow-up time was years on average. The MHHS increased from 70 points before the surgery to 91 points after the surgery , WOMAC pain score decreased from 4 points before surgery to zero after the surgery . According to the logistic regression analysis, for every unit increased in the lateral center-edge angle, the postoperative modified Harris score was 1.2 times more likely to be classified as excellent[odds ratio=1.183, 95%confidence interval, P<0.01]. For each increase of age by one unit, the probability of preoperative pain level increasing by one level was 1.1 times higher [OR=1.090, 95%CI, P=0.012]. For each increase in body mass index by one unit, the probability of preoperative pain level increasing by one level was 1.2 times higher [OR=1.244, 95%CI, P=0.011]. Regression analysis of other factors showed no significant correlation with preoperative pain and postoperative functional score.Conclusions:The overall function score of patients after Bernese periacetabular osteotomy is significantly improved, and the pain symptoms are significantly reduced. The patients with larger lateral center-edge angle may have better joint function after surgery, while the patients with elder age and lager body mass index may suffer more severe pain收起

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