Periacetabular Osteotomy for Developmental Dysplasia of the Hip and Femoroacetabular Impingement: A Study Using the U.K. Non-Arthroplasty Hip Registry (NAHR) Data Set.
Acetabulum
/ abnormalities
Adult
Databases, Factual
/ statistics & numerical data
Developmental Dysplasia of the Hip
/ epidemiology
Female
Femoracetabular Impingement
/ epidemiology
Hip Joint
/ abnormalities
Humans
Male
Minimal Clinically Important Difference
Osteoarthritis, Hip
/ etiology
Osteotomy
/ methods
Patient Reported Outcome Measures
Registries
/ statistics & numerical data
Retrospective Studies
United Kingdom
/ epidemiology
Journal
The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
Titre abrégé: J Bone Joint Surg Am
Pays: United States
ID NLM: 0014030
Informations de publication
Date de publication:
05 Aug 2020
05 Aug 2020
Historique:
entrez:
10
8
2020
pubmed:
10
8
2020
medline:
20
2
2021
Statut:
ppublish
Résumé
Periacetabular osteotomy (PAO) is a well-recognized procedure for the treatment of hip dysplasia in young adults and can be used for the surgical management of femoroacetabular impingement (FAI) with acetabular retroversion. The aim of this study was to use a national database to assess the outcomes of PAO for developmental dysplasia of the hip (DDH) and for FAI. All patients in whom an isolated PAO had been performed between January 2012 and February 2019 were identified in the Non-Arthroplasty Hip Registry (NAHR). Their outcomes were assessed using the EuroQol-5 Dimensions (EQ-5D) index and the International Hip Outcome Tool (iHOT)-12 preoperatively and then at 6 months, 12 months, and 2 years postoperatively. Six hundred and thirty (630) PAOs were identified, with 558 (89%) performed for DDH and 72 (11%) performed for FAI. Most patients (90%) were female. The mean age in the DDH group (31.2 years) was significantly higher (p < 0.0001) than that in the FAI group (26.5 years). There were no other significant between-group demographic differences. Preoperatively and at each follow-up time-period, iHOT-12 scores were better in the DDH group than in the FAI group; however, only the preoperative scores differed significantly. There was significant improvement between the preoperative and 6-month iHOT-12 and EQ-5D index scores in both the DDH and the FAI group. This improvement was maintained at 12 months postoperatively, by which time almost 90% of the patients had achieved the minimum clinically important difference (MCID) in their iHOT-12 score. This study shows that PAO is a successful surgical intervention for DDH and FAI in the short term, with significant improvement in patient-reported outcome scores that is maintained up to 2 years postoperatively. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Sections du résumé
BACKGROUND
BACKGROUND
Periacetabular osteotomy (PAO) is a well-recognized procedure for the treatment of hip dysplasia in young adults and can be used for the surgical management of femoroacetabular impingement (FAI) with acetabular retroversion. The aim of this study was to use a national database to assess the outcomes of PAO for developmental dysplasia of the hip (DDH) and for FAI.
METHODS
METHODS
All patients in whom an isolated PAO had been performed between January 2012 and February 2019 were identified in the Non-Arthroplasty Hip Registry (NAHR). Their outcomes were assessed using the EuroQol-5 Dimensions (EQ-5D) index and the International Hip Outcome Tool (iHOT)-12 preoperatively and then at 6 months, 12 months, and 2 years postoperatively.
RESULTS
RESULTS
Six hundred and thirty (630) PAOs were identified, with 558 (89%) performed for DDH and 72 (11%) performed for FAI. Most patients (90%) were female. The mean age in the DDH group (31.2 years) was significantly higher (p < 0.0001) than that in the FAI group (26.5 years). There were no other significant between-group demographic differences. Preoperatively and at each follow-up time-period, iHOT-12 scores were better in the DDH group than in the FAI group; however, only the preoperative scores differed significantly. There was significant improvement between the preoperative and 6-month iHOT-12 and EQ-5D index scores in both the DDH and the FAI group. This improvement was maintained at 12 months postoperatively, by which time almost 90% of the patients had achieved the minimum clinically important difference (MCID) in their iHOT-12 score.
CONCLUSIONS
CONCLUSIONS
This study shows that PAO is a successful surgical intervention for DDH and FAI in the short term, with significant improvement in patient-reported outcome scores that is maintained up to 2 years postoperatively.
LEVEL OF EVIDENCE
METHODS
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Identifiants
pubmed: 32769597
doi: 10.2106/JBJS.18.01387
pii: 00004623-202008050-00008
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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