关节囊切开与髋关节镜分别结合髋臼周围截骨术治疗成人发育性髋关节发育不良的疗效比较

Efficacy of capsulotomy or hip arthroscopy combined with periacetabular osteotomy in the treatment of developmental dysplasia of the hip in adults

目的:探究关节囊切开与髋关节镜分别结合髋臼周围截骨术治疗成人发育性髋关节发育不良的疗效。方法:回顾分析72例2021年5月至2022年6月入住我院的成人发育性髋关节发育不良患者的临床资料,分为关节囊切开组(n=35)和髋关节镜组(n=37)。对比两组患者的手术情况,术前及术后采用髋骨X线检查测定髋关节情况,采用非骨关节炎髋关节评分(Non-Arthritis Hip Score,NAHS)测定患者关节功能,采用日常生活能力量表(Hip Outcome Score Activity of Daily Living Scale,HOS-ADL)测定患者活动能力,记录患者术后并发症发生情况。结果:两组患者手术情况,术后3 m术后髋关节情况对比均无明显差异(P>0.05),髋关节镜组相较于关节囊切开组术后3 m NAHS、HOS-ADL得分更高,坐骨神经损伤表现发生率明显更低(P<0.05)。结论:髋关节镜截骨术在短期改善成人发育性髋关节不良患者关节功能方面优势明显,可防止坐骨神经损伤。

Objective:To explore the efficacy of capsulotomy or hip arthroscopy combined with periacetabular osteotomy in treating adults with developmental dysplasia of the hip.Methods:The clinical data of 72 adult patients with developmental dysplasia of the hip admitted to the hospital from May 2021 to June 2022 were retrospectively analyzed.The patients were divided into a capsulotomy group(n=35)and a hip arthroscopy group(n=37).The surgical conditions were compared between the two groups of patients.A hip bone X-ray examination was performed to determine hip joint status before and after surgery.Non-Arthritis Hip Score(NAHS)was used to determine the joint function of patients.Hip Outcome Score Activity of Daily Living Scale(HOS-ADL)was applied to assess the acting ability,and the postoperative complications were recorded.Results:There were no significant differences in surgical conditions and hip conditions at 3 months after surgery between the two groups of patients(P>0.05).Compared with the capsulotomy group,the scores of NAHS and HOS-ADL at 3 months after surgery were higher while the incidence rate of sciatic nerve injury was significantly lower in the hip arthroscopy group(P<0.05).Conclusion:Hip arthroscopy osteotomy has obvious advantages in a shortterm improvement of joint function in adult patients with developmental dysplasia of the hip,and it can prevent sciatic nerve injury.