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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >What is The Impact of PAO Surgery on Patient Function and Activity Levels?
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What is The Impact of PAO Surgery on Patient Function and Activity Levels?

机译：PAO手术对患者功能和活动水平有何影响？

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Objectives: The Bernese periacetabular osteotomy (PAO) is becoming a widely utilized procedure. Patients are younger, highly active, and may desire to return to sport activity. Counseling and managing expectations in these patients is challenging as there is limited information regarding activity level after PAO. The purpose of this study was to analyze physical activity levels after PAO in a large, prospective multicenter cohort. Methods: Assessment of prospectively collected data from a multicenter group included 456 hips treated by PAO for hip dysplasia. After exclusions, 359 hips (80 male, 279 female) remained with a mean age of 25.9 years and mean BMI of 25. Demographics, radiographic measures, and clinical outcomes were evaluated preoperatively, at 1 year follow-up, and at minimum 2 years postoperatively (mean 44.9 months). Activity level was assessed with the University of California-Los Angeles (UCLA) activity score, patients were stratified into low, moderate, and high activity groups based on preoperative function. Descriptive statistics and linear regressions were performed for the primary outcome of change in UCLA. Results: UCLA scores were improved on average 0.6 points at final follow up (p = 0.001). When stratified, the low activity and moderate activity groups had significant improvement in UCLA scores (p<.0001 and p=0007) while the high activity group saw a decrease in UCLA scores (p<.0001). mHHS, HOOS Pain, and HOOS Sports and Recreation scores were significantly improved across all activity levels. Univariable linear regression analysis identified prior ipsilateral surgery, arthroscopy at time of PAO, and preoperative ACEA to be predictors of the change in UCLA score (p<0.05). With the multivariable model, the effect of prior ispilateral surgery was maintained (p = 0.002). Conclusion: The data suggests that improvements in activity level and function can be expected following PAO surgery, with greater gains experienced by patients with lower preoperative level of activity. Figure 1. Change in UCLA activity score after PAO, stratified by preoperative activity. Figure 2. Change in Modified Harris Hip (mHHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) pain subscore and HOOS sports and recreation subscore, stratified by preoperative activity.
机译：目的：伯尔尼髋臼近端截骨术（PAO）成为一种广泛使用的手术。患者较年轻，活跃度很高，可能希望重新参加运动。在PAO之后，有关活动水平的信息有限，因此难以指导和管理这些患者的期望值。这项研究的目的是分析大型，预期的多中心队列中PAO后的身体活动水平。方法：从多中心组前瞻性收集的数据进行评估，包括456例接受过PAO治疗的髋关节发育不良的髋关节。排除后，剩余359髋（男80例，女279例），平均年龄25.9岁，平均BMI为25。术前，随访1年和至少2年评估了人口统计学，影像学和临床结果术后（平均44.9个月）。用加州大学洛杉矶分校（UCLA）的活动评分评估活动水平，根据术前功能将患者分为低，中，高活动组。对UCLA变化的主要结果进行了描述性统计和线性回归。结果：最终随访时，UCLA评分平均提高了0.6分（p = 0.001）。分层后，低活动和中度活动组的UCLA得分有显着改善（p <.0001和p = 0007），而高活动组的UCLA得分有所降低（p <.0001）。在所有活动水平上，mHHS，HOOS疼痛和HOOS运动与休闲得分均得到显着改善。单变量线性回归分析确定了先前的同侧手术，PAO时的关节镜检查和术前ACEA是UCLA评分变化的预测因素（p <0.05）。使用多变量模型，可以维持先前的同侧手术的效果（p = 0.002）。结论：数据表明，PAO手术后可以预期活动水平和功能的改善，术前活动水平较低的患者获益更大。图1. PAO后UCLA活性评分的变化，按术前活动分层。图2.改良的Harris Hip（mHHS），髋关节残疾和骨关节炎结果评分（HOOS）疼痛评分以及HOOS运动和休闲评分的变化，按术前活动进行了分层。

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