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Periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required?

Patients with developmental dysplasia of the hip (DDH) who undergo periacetabular osteotomy (PAO) often have labral tears. The objective of this retrospective study was to compare PAO alone with PAO combined with arthrotomy or arthroscopy in DDH patients who had a full-thickness labral tear on magne...

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Autores principales: Thanacharoenpanich, Songkiat, Boyle, Matthew J, Murphy, Robert F, Miller, Patricia E, Millis, Michael B, Kim, Young-Jo, Yen, Yi-Meng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798119/
https://www.ncbi.nlm.nih.gov/pubmed/29423247
http://dx.doi.org/10.1093/jhps/hnx048
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author Thanacharoenpanich, Songkiat
Boyle, Matthew J
Murphy, Robert F
Miller, Patricia E
Millis, Michael B
Kim, Young-Jo
Yen, Yi-Meng
author_facet Thanacharoenpanich, Songkiat
Boyle, Matthew J
Murphy, Robert F
Miller, Patricia E
Millis, Michael B
Kim, Young-Jo
Yen, Yi-Meng
author_sort Thanacharoenpanich, Songkiat
collection PubMed
description Patients with developmental dysplasia of the hip (DDH) who undergo periacetabular osteotomy (PAO) often have labral tears. The objective of this retrospective study was to compare PAO alone with PAO combined with arthrotomy or arthroscopy in DDH patients who had a full-thickness labral tear on magnetic resonance imaging. In total, 47 hips in the PAO group (PAO) were compared with 60 hips in the PAO with concomitant arthrotomy or arthroscopy (PAO-A) with respect to Hip Disability and Osteoarthritis Outcome Score (HOOS), modified Harris Hip Score (mHHS), Visual Analog Scale (VAS), clinical and radiographic outcomes at a median of 29 months. Reoperation rate and complications were compared between two groups of treatment. The PAO group was younger than the PAO-A group (25.2 ± 9.7 versus 31.3 ± 8.3). The PAO group was more likely to have worse dysplasia: lateral center edge angle (7.6°±9.63° versus 10.8°±6.85°) and anterior center edge angle (4°±12.92° versus 10.8°±9.92°). The PAO group had a higher preoperative mHHS (65.2 ± 15.3 versus 57.8 ± 14.8) and HOOS (66.3 ± 17.5 versus 55.8 ± 20.1). There were no significant differences in final functional outcome scores across treatment groups: mHHS (PAO; 86.8 ± 12.4 versus PAO-A, 83.3 ± 17.2), HOOS (86.5 ± 13.3 versus 82.5 ± 16.8) and VAS (2.5 ± 2.8 versus 2.5 ± 3.1). There was no difference in reoperation rate between two groups (6.4% versus 11.6%, P = 0.51). The overall complication rate was lower in the PAO group (26% versus 68%), but major complications were comparable. On the basis of our data, we were not able to conclusively demonstrate a clear benefit for the routine treatment of all labral tears; however, arthrotomy or arthroscopy may play a role in some conditions.
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spelling pubmed-57981192018-02-08 Periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required? Thanacharoenpanich, Songkiat Boyle, Matthew J Murphy, Robert F Miller, Patricia E Millis, Michael B Kim, Young-Jo Yen, Yi-Meng J Hip Preserv Surg Research Articles Patients with developmental dysplasia of the hip (DDH) who undergo periacetabular osteotomy (PAO) often have labral tears. The objective of this retrospective study was to compare PAO alone with PAO combined with arthrotomy or arthroscopy in DDH patients who had a full-thickness labral tear on magnetic resonance imaging. In total, 47 hips in the PAO group (PAO) were compared with 60 hips in the PAO with concomitant arthrotomy or arthroscopy (PAO-A) with respect to Hip Disability and Osteoarthritis Outcome Score (HOOS), modified Harris Hip Score (mHHS), Visual Analog Scale (VAS), clinical and radiographic outcomes at a median of 29 months. Reoperation rate and complications were compared between two groups of treatment. The PAO group was younger than the PAO-A group (25.2 ± 9.7 versus 31.3 ± 8.3). The PAO group was more likely to have worse dysplasia: lateral center edge angle (7.6°±9.63° versus 10.8°±6.85°) and anterior center edge angle (4°±12.92° versus 10.8°±9.92°). The PAO group had a higher preoperative mHHS (65.2 ± 15.3 versus 57.8 ± 14.8) and HOOS (66.3 ± 17.5 versus 55.8 ± 20.1). There were no significant differences in final functional outcome scores across treatment groups: mHHS (PAO; 86.8 ± 12.4 versus PAO-A, 83.3 ± 17.2), HOOS (86.5 ± 13.3 versus 82.5 ± 16.8) and VAS (2.5 ± 2.8 versus 2.5 ± 3.1). There was no difference in reoperation rate between two groups (6.4% versus 11.6%, P = 0.51). The overall complication rate was lower in the PAO group (26% versus 68%), but major complications were comparable. On the basis of our data, we were not able to conclusively demonstrate a clear benefit for the routine treatment of all labral tears; however, arthrotomy or arthroscopy may play a role in some conditions. Oxford University Press 2018-01-11 /pmc/articles/PMC5798119/ /pubmed/29423247 http://dx.doi.org/10.1093/jhps/hnx048 Text en © The Author(s) 2018. Published by Oxford University Press http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Research Articles
Thanacharoenpanich, Songkiat
Boyle, Matthew J
Murphy, Robert F
Miller, Patricia E
Millis, Michael B
Kim, Young-Jo
Yen, Yi-Meng
Periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required?
title Periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required?
title_full Periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required?
title_fullStr Periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required?
title_full_unstemmed Periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required?
title_short Periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required?
title_sort periacetabular osteotomy for developmental hip dysplasia with labral tears: is arthrotomy or arthroscopy required?
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798119/
https://www.ncbi.nlm.nih.gov/pubmed/29423247
http://dx.doi.org/10.1093/jhps/hnx048
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