Abstract：
OBJECTIVE: To evaluate the literature on patients undergoing periacetabular osteotomy after failed hip arthroscopy (PAO-FHA) for (1) patient demographics and hip morphology, (2) changes in preoperative to postoperative patient-reported outcomes (PROs), and (3) PROs in comparison to primary periacetabular osteotomy (PAO) patients.
METHODS: A systematic literature search of Pubmed, CINAHL/Medline, and cochrane databases was performed in accordance with PRISMA guidelines. The search phrase was \"(periacetabular osteotomy or PAO or rotational osteotomy) and (hip arthroscopy or arthroscopic)\". The titles, abstracts, and full texts were screened for studies on PAO-FHA. Study quality was assessed, and relevant data were collected. A meta-analysis was not performed due to study heterogeneity.
RESULTS: The search identified 7 studies, including 151 hips (148 patients, 93.9% female) undergoing PAO-FHA, out of an initial 593 studies, with three Level IV and four Level III studies. Mean time from hip arthroscopy to PAO ranged from 17.0 to 29.6 months. Heterogenous hip morphologies and radiologic findings prior to PAO were observed, though patients most frequently demonstrated moderate-to-severe dysplasia (mean or median lateral center edge angle < 20°) and minimal osteoarthritis (Tönnis grade 0 or 1). In all 5 studies that reported concomitant procedures with PAO, femoral and/or acetabular osteoplasty was performed via arthroscopy or arthrotomy. Following PAO-FHA, radiographic acetabular coverage and PROs improved in all 6 studies that reported postoperative outcomes. All four comparative studies of primary PAO vs. PAO-FHA included patients with mean or median LCEAs < 20°, reporting mixed outcomes for the optimal treatment approach.
CONCLUSIONS: PAO-FHA is reported in a heterogenous patient population that frequently includes hips with moderate-to-severe dysplasia and minimal osteoarthritis. Regardless of hip morphology or concomitant procedures, all studies that reported postoperative outcomes demonstrated improved PROs following PAO-FHA.
METHODS: Level IV.
METHODS: A systematic literature search of Pubmed, CINAHL/Medline, and cochrane databases was performed in accordance with PRISMA guidelines. The search phrase was \"(periacetabular osteotomy or PAO or rotational osteotomy) and (hip arthroscopy or arthroscopic)\". The titles, abstracts, and full texts were screened for studies on PAO-FHA. Study quality was assessed, and relevant data were collected. A meta-analysis was not performed due to study heterogeneity.
RESULTS: The search identified 7 studies, including 151 hips (148 patients, 93.9% female) undergoing PAO-FHA, out of an initial 593 studies, with three Level IV and four Level III studies. Mean time from hip arthroscopy to PAO ranged from 17.0 to 29.6 months. Heterogenous hip morphologies and radiologic findings prior to PAO were observed, though patients most frequently demonstrated moderate-to-severe dysplasia (mean or median lateral center edge angle < 20°) and minimal osteoarthritis (Tönnis grade 0 or 1). In all 5 studies that reported concomitant procedures with PAO, femoral and/or acetabular osteoplasty was performed via arthroscopy or arthrotomy. Following PAO-FHA, radiographic acetabular coverage and PROs improved in all 6 studies that reported postoperative outcomes. All four comparative studies of primary PAO vs. PAO-FHA included patients with mean or median LCEAs < 20°, reporting mixed outcomes for the optimal treatment approach.
CONCLUSIONS: PAO-FHA is reported in a heterogenous patient population that frequently includes hips with moderate-to-severe dysplasia and minimal osteoarthritis. Regardless of hip morphology or concomitant procedures, all studies that reported postoperative outcomes demonstrated improved PROs following PAO-FHA.
METHODS: Level IV.
摘要：
目的：评估关于髋关节镜（PAO-FHA）失败后髋臼周围截骨术患者的文献（1）患者的人口统计学和髋关节形态，（2）术前术后患者报告结果（PRO）的变化，和（3）PROs与初次髋臼周围截骨术（PAO）患者的比较。
方法：对Pubmed，CINAHL/Medline,和Cochrane数据库按照PRISMA指南进行。搜索短语为“（髋臼周围截骨术或PAO或旋转截骨术）和（髋关节镜或关节镜）”。标题，摘要,并筛选了有关PAO-FHA的研究全文。评估研究质量，并收集相关数据。由于研究异质性，未进行荟萃分析。
结果：搜索确定了7项研究，包括151髋(148名患者，93.9%女性)接受PAO-FHA，在最初的593项研究中，有三个IV级和四个III级研究。从髋关节镜检查到PAO的平均时间为17.0至29.6个月。观察到PAO之前的异源性髋关节形态和放射学发现，尽管患者最常表现为中度至重度发育不良（平均或中位外侧中心边缘角<20°）和轻度骨关节炎（Tönnnis等级0或1）。在所有5项报告与PAO合并手术的研究中，通过关节镜或关节切开术进行股骨和/或髋臼骨成形术.在PAO-FHA之后,在所有6项报告术后结局的研究中,影像学髋臼覆盖率和PRO均得到改善.初级PAO与初级PAO的所有四项比较研究PAO-FHA包括平均或中位LCEA<20°的患者，报告最佳治疗方法的混合结果。
结论：PAO-FHA在异质性患者人群中报告，该人群通常包括中度至重度发育不良和轻度骨关节炎的髋部。无论髋关节形态或伴随手术，所有报告术后结局的研究均显示PAO-FHA术后PRO改善.
方法：四级。
方法：对Pubmed，CINAHL/Medline,和Cochrane数据库按照PRISMA指南进行。搜索短语为“（髋臼周围截骨术或PAO或旋转截骨术）和（髋关节镜或关节镜）”。标题，摘要,并筛选了有关PAO-FHA的研究全文。评估研究质量，并收集相关数据。由于研究异质性，未进行荟萃分析。
结果：搜索确定了7项研究，包括151髋(148名患者，93.9%女性)接受PAO-FHA，在最初的593项研究中，有三个IV级和四个III级研究。从髋关节镜检查到PAO的平均时间为17.0至29.6个月。观察到PAO之前的异源性髋关节形态和放射学发现，尽管患者最常表现为中度至重度发育不良（平均或中位外侧中心边缘角<20°）和轻度骨关节炎（Tönnnis等级0或1）。在所有5项报告与PAO合并手术的研究中，通过关节镜或关节切开术进行股骨和/或髋臼骨成形术.在PAO-FHA之后,在所有6项报告术后结局的研究中,影像学髋臼覆盖率和PRO均得到改善.初级PAO与初级PAO的所有四项比较研究PAO-FHA包括平均或中位LCEA<20°的患者，报告最佳治疗方法的混合结果。
结论：PAO-FHA在异质性患者人群中报告，该人群通常包括中度至重度发育不良和轻度骨关节炎的髋部。无论髋关节形态或伴随手术，所有报告术后结局的研究均显示PAO-FHA术后PRO改善.
方法：四级。
