PDF(Pubmed)
Abstract：
BACKGROUND: Multiple epiphyseal dysplasia (MED) is a rare congenital bone dysplasia. Patients with MED develop secondary hip osteoarthritis as early as the third to the fourth decade. Currently, there is no consensus on the prevention of the progressive hip osteoarthritis secondary to MED. The Bernese periacetabular osteotomy (PAO) is a joint-preserving surgery to reshape acetabulum and extend femoral head coverage. However, there is no documentary evidence for the effect of the procedure on MED hips.
METHODS: We analyzed the preliminary outcomes following the Bernese PAO in 6 MED hips. The average age at the time of surgery was 14.3 years (range from 11.4 to 17.2 years). For our study interest of time efficiency, radiographic parameters were analyzed preoperatively and 1 year postoperatively. The hip function was evaluated by the Harris Hip Score (HHS) before and after surgery.
RESULTS: The mean follow-up time was 1.7 years. The mean lateral center-edge angle increased from 3.8° to 47.1° (p = 0.02), anterior center-edge angle increased from 7.3° to 35.1° (p = 0.02), and acetabulum index decreased from 27.8° to 14.6° (p = 0.04). The femoral head coverage ratio increased from 66.8% to 100% (p = 0.02). The post-operative anteroposterior pelvic radiograph demonstrated all preoperative broken Shenton lines were reversed. The mean HHS improved from 67.3 to 86.7 (p = 0.05).
CONCLUSIONS: Bernese PAO is a feasible treatment for hip disorders in MED patients. It reshapes acetabular and femoral morphology efficiently. In our study, the preliminary results showed the procedure not only improved radiographic outcomes but also hip function.
METHODS: We analyzed the preliminary outcomes following the Bernese PAO in 6 MED hips. The average age at the time of surgery was 14.3 years (range from 11.4 to 17.2 years). For our study interest of time efficiency, radiographic parameters were analyzed preoperatively and 1 year postoperatively. The hip function was evaluated by the Harris Hip Score (HHS) before and after surgery.
RESULTS: The mean follow-up time was 1.7 years. The mean lateral center-edge angle increased from 3.8° to 47.1° (p = 0.02), anterior center-edge angle increased from 7.3° to 35.1° (p = 0.02), and acetabulum index decreased from 27.8° to 14.6° (p = 0.04). The femoral head coverage ratio increased from 66.8% to 100% (p = 0.02). The post-operative anteroposterior pelvic radiograph demonstrated all preoperative broken Shenton lines were reversed. The mean HHS improved from 67.3 to 86.7 (p = 0.05).
CONCLUSIONS: Bernese PAO is a feasible treatment for hip disorders in MED patients. It reshapes acetabular and femoral morphology efficiently. In our study, the preliminary results showed the procedure not only improved radiographic outcomes but also hip function.
摘要：
背景：多发性骨骨发育不良（MED）是一种罕见的先天性骨发育不良。MED患者早在第三至第四个十年就发展为继发性髋关节骨关节炎。目前,对于预防MED继发的进行性髋关节骨关节炎尚无共识.Bernese髋臼周围截骨术（PAO）是一种保留关节的手术，可重塑髋臼并扩大股骨头覆盖范围。然而,没有书面证据证明该程序对MED臀部的影响。
方法：我们分析了BernesePAO在6个MED臀部的初步结果。手术时的平均年龄为14.3岁（范围从11.4到17.2岁）。为了我们对时间效率的研究兴趣，术前和术后1年对影像学参数进行分析.手术前后采用Harris髋关节评分(HHS)评价髋关节功能。
结果：平均随访时间为1.7年。平均横向中心边缘角从3.8°增加到47.1°（p=0.02），前中心-边缘角从7.3°增加到35.1°（p=0.02），髋臼指数从27.8°下降到14.6°(p=0.04)。股骨头覆盖率从66.8％增加到100％（p=0.02）。术后骨盆前后X线片显示所有术前断裂的Shenton线都被逆转。平均HHS从67.3提高到86.7（p=0.05）。
结论：BernesePAO是治疗MED患者髋关节疾病的可行方法。它有效地重塑髋臼和股骨形态。在我们的研究中,初步结果显示,该手术不仅改善了影像学结果,而且改善了髋关节功能.
方法：我们分析了BernesePAO在6个MED臀部的初步结果。手术时的平均年龄为14.3岁（范围从11.4到17.2岁）。为了我们对时间效率的研究兴趣，术前和术后1年对影像学参数进行分析.手术前后采用Harris髋关节评分(HHS)评价髋关节功能。
结果：平均随访时间为1.7年。平均横向中心边缘角从3.8°增加到47.1°（p=0.02），前中心-边缘角从7.3°增加到35.1°（p=0.02），髋臼指数从27.8°下降到14.6°(p=0.04)。股骨头覆盖率从66.8％增加到100％（p=0.02）。术后骨盆前后X线片显示所有术前断裂的Shenton线都被逆转。平均HHS从67.3提高到86.7（p=0.05）。
结论：BernesePAO是治疗MED患者髋关节疾病的可行方法。它有效地重塑髋臼和股骨形态。在我们的研究中,初步结果显示,该手术不仅改善了影像学结果,而且改善了髋关节功能.
