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著者: Shiho Kanezaki, Shigeru Nakamura, Masaki Nakamura, Isao Yokota, Takashi Matsushita
雑誌名: Int Orthop. 2017 Feb;41(2):265-270. doi: 10.1007/s00264-016-3183-6. Epub 2016 Apr 28.
Abstract/Text
PURPOSE: Rotational acetabular osteotomy (RAO) is one of the surgical procedures for painful dysplastic hips. Although several risk factors for poor outcome of RAO have been reported, the presence of a curtain osteophyte in the acetabulum has not been evaluated as a possible risk factor. This study aimed to analyze the risk factors affecting the outcome of RAO and to clarify whether curtain osteophytes are one of the risk factors.
METHODS: We retrospectively analyzed 87 hips in 78 patients with a mean age of 36 (range, 13-54) years. The mean follow-up period was 8.3 (range, 2.1-19.5) years. The radiographic severity of osteoarthritis was classified into four stages: pre-arthrosis, initial stage, advanced stage, and terminal stage. The Japanese Orthopaedic Association (JOA) hip score was used for clinical evaluation. Poor outcome was defined as a hip with a JOA score < 80 points or terminal-stage osteoarthritis at final follow-up. Several factors were evaluated by logistic regression analysis.
RESULTS: At final follow-up, ten hips had a JOA score < 80 and nine hips had progressed to terminal-stage osteoarthritis. Since five hips had a JOA score < 80 as well as terminal-stage osteoarthritis, a total of 14 hips were determined to have poor outcome. An additional ten years of age at surgery, pre-operative minimal joint space < 2 mm, presence of a curtain osteophyte, and fair/poor congruency in abduction were identified as significant risk factors for poor outcome of RAO.
CONCLUSIONS: Hips with curtain osteophyte should be evaluated carefully before RAO.
PMID 27125434 Int Orthop. 2017 Feb;41(2):265-270. doi: 10.1007/s00264-016-3183-6. Epub 2016 Apr 28.
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