中国骨伤2025，Vol.38Issue(8)：828-834,7.DOI:10.12200/j.issn.1003-0034.20241150
髋关节镜手术对临界型发育性髋关节发育不良早期疗效及安全性分析
Analysis of early efficacy and safety of hip arthroscopy in patients with borderline developmental dysplasia of the hip
摘要
Abstract
Objective To explore the early efficacy and safety of hip arthroscopy in the treatment of patients with border-line developmental dysplasia of the hip(BDDH).Methods A total of 111 patients diagnosed with BDDH from January 2020 to December 2022 were selected and divided into two groups according to the surgical method.Among them,63 patients who un-derwent arthroscopy were assigned to the arthroscopy group,including 22 males and 41 females with an average age of(35.67±6.83)years;48 patients who underwent periacetabular osteotomy were assigned to the PAO group,including 18 males and 30 females with an average age of(36.85±7.10)years.The operation time,hospital stay,blood loss,rehabilitation time,complica-tion rate,and reoperation rate were recorded in both groups.Imaging indicators of the two groups were measured and recorded.The modified Harris hip score(mHHS),nonarthritic hip score(NAHS),and hip outcome score-activity of daily living scale(HOS-ADL)were used to evaluate hip function and quality of life before and after surgery.Results All patients were followed up for 12 months.The operation time(90.43±9.85)min,hospital stay(4.32±0.56)days,rehabilitation time(15.22±2.15)weeks,blood loss(25.69±6.57)ml,and number of complications(15 cases)in the arthroscopy group were all lower than those in the PAO group(117.25±15.83)min,(5.81±0.92)days,(21.10±3.74)weeks,(358.52±126.73)ml,30 cases,with statisti-cally significant differences(P＜0.05).At the last follow-up after treatment,the lateral center edge angle(LCEA)(19.82±1.90)° and anterior center edge angle(ACEA)(20.01±1.85)° in the arthroscopy group decreased compared with those before treatment(21.43±2.10)°,(21.54±2.05)°,while in the PAO group,the LCEA(33.03±3.45)° and ACEA(33.48±4.22)° at the last follow-up after treatment increased compared with those before treatment,with statistically significant differences(P＜0.05).The Tönnis angle in the arthroscopy group after treatment(11.05±1.83)° increased compared with that before treat-ment,while in the PAO group,the Tönnis angle at the last follow-up after treatment(2.98±0.75)° decreased compared with that before treatment,with statistically significant differences(P＜0.05).In the arthroscopy group,the extrusion index(30.68±2.85)and Tönnis grade after treatment increased compared with those before treatment,while the α angle after treatment(38.79±4.27)° significantly decreased compared with that before treatment,with statistically significant differences(P＜0.05);in the PAO group,the extrusion index(15.03±2.18)and α angle(53.58±6.02)° after treatment significantly decreased compared with those before treatment,with statistically significant differences(P＜0.05).The mHHS score at the last follow-up after treat-ment in the arthroscopy group(86.41±7.33)was higher than that in the PAO group(81.02±6.49),with a statistically signifi-cant difference(P＜0.05).At 6 months after treatment,the NAHS(69.83±6.53)and HOS-ADL scores(78.84±7.39)in the arthroscopy group were higher than those in the PAO group(64.10±6.02),(75.31±7.01),with statistically significant differ-ences(P＜0.01);at the last follow-up after treatment,the NAHS(87.63±7.60)and HOS-ADL scores(88.94±8.11)in the arthroscopy group were higher than those in the PAO group(81.63±7.03),(83.63±7.92),with statistically significant differ-ences(P＜0.05).Conclusion Compared with PAO,hip arthroscopy shows better early to mid-term clinical efficacy in the treat-ment of BDDH patients.However,PAO has more advantages in improving acetabular imaging indicators of BDDH patients,while hip arthroscopy only improves the α angle of patients.Meanwhile,hip arthroscopy causes less trauma to patients,reduces blood loss,and is more conducive to the subsequent recovery of patients.关键词
髋关节/临界型/发育性/发育不良/疗效Key words
Hip joint/Borderline type/Developmental/Dysplasia/Efficacy分类
医药卫生引用本文复制引用
艾柯,王雷,杨军,陈杰能..髋关节镜手术对临界型发育性髋关节发育不良早期疗效及安全性分析[J].中国骨伤,2025,38(8):828-834,7.基金项目
湖北省自然科学基金项目(编号:2021CFB530)National Natural Science Foundation of Hubei Province(No.2021CFB530) （编号:2021CFB530）
