PDF(Pubmed)
Abstract：
UNASSIGNED: Hip dysplasia is a leading cause of hip osteoarthritis. While periacetabular osteotomy (PAO) is effective for relieving pain and dysfunction caused by hip dysplasia in adolescents and young adults, there is concern that patients over 40 years of age will have an increased risk of persistent dysfunction and need for total hip arthroplasty. Current available evidence for PAO in older adults is limited and there is no systematic review in the literature focusing on this topic. The current systematic review offers insight into the demographics, patient-reported outcome measure (PROM) scores, and hip survivorship from total hip arthroplasty in patients over 40 years older treated for hip dysplasia with PAO.
UNASSIGNED: The review was conducted under the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Databases that were searched included PubMed, OVID Medline, SCOPUS, Embase, Cochrane Library, and clinicaltrials.gov. Studies were screened based on predetermined inclusion and exclusion criteria.
UNASSIGNED: Five studies were included in this systematic review. Enrollment years were 1990-2013. In total, there were 335 hips with mean ages between 43.5-47.2 years. Mean follow up was 4-10.8 years. Most patients that underwent hip preservation had Tonnis osteoarthritis grade 0-1. There was contradicting evidence whether patients >40 years did better or worse compared to <40 years; although, most patients in the >40 years group had good outcomes after PAO. PAO survivorship ranged from 67-100% depending on the study. Complications ranged from 2-36% of cases depending on the study; although, none of these complications had lasting effects.
UNASSIGNED: Patients over 40 years old appear to have positive outcomes when treated for hip dysplasia with PAO, though these patients were likely selected for no to minimal osteoarthritis, high functional status, and good health. PAO should be considered for patients with hip dysplasia over 40 years old without hip arthritis, though we recommend very selective indications. Level of Evidence: II.
UNASSIGNED: The review was conducted under the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Databases that were searched included PubMed, OVID Medline, SCOPUS, Embase, Cochrane Library, and clinicaltrials.gov. Studies were screened based on predetermined inclusion and exclusion criteria.
UNASSIGNED: Five studies were included in this systematic review. Enrollment years were 1990-2013. In total, there were 335 hips with mean ages between 43.5-47.2 years. Mean follow up was 4-10.8 years. Most patients that underwent hip preservation had Tonnis osteoarthritis grade 0-1. There was contradicting evidence whether patients >40 years did better or worse compared to <40 years; although, most patients in the >40 years group had good outcomes after PAO. PAO survivorship ranged from 67-100% depending on the study. Complications ranged from 2-36% of cases depending on the study; although, none of these complications had lasting effects.
UNASSIGNED: Patients over 40 years old appear to have positive outcomes when treated for hip dysplasia with PAO, though these patients were likely selected for no to minimal osteoarthritis, high functional status, and good health. PAO should be considered for patients with hip dysplasia over 40 years old without hip arthritis, though we recommend very selective indications. Level of Evidence: II.
摘要：
■髋关节发育不良是髋关节骨关节炎的主要原因。虽然髋臼周围截骨术（PAO）可有效缓解青少年和年轻人髋关节发育不良引起的疼痛和功能障碍，人们担心40岁以上的患者发生持续性功能障碍的风险会增加,需要进行全髋关节置换术.目前关于老年人PAO的现有证据有限，文献中没有针对该主题的系统综述。当前的系统审查提供了对人口统计学的见解，患者报告结果测量（PROM）评分，40岁以上接受PAO治疗的髋关节发育不良患者的全髋关节置换术和髋关节存活率。
■审查是根据系统审查和荟萃分析（PRISMA）的首选报告项目指南进行的。搜索的数据库包括PubMed,OVIDMedline,Scopus,Embase,科克伦图书馆,和临床试验。根据预定的纳入和排除标准筛选研究。
■本系统综述包括5项研究。注册年份为1990-2013年。总的来说,有335髋，平均年龄在43.5-47.2岁之间。平均随访4-10.8年。大多数接受髋关节保留的患者患有Tonnis骨关节炎0-1级。有矛盾的证据表明，与<40岁相比，>40岁的患者表现更好还是更差；尽管，>40岁组的大多数患者在PAO后有良好的预后。根据研究，PAO生存率为67-100％。根据研究，并发症的范围为2-36%的病例；尽管，这些并发症均无持久影响.
■40岁以上的患者在使用PAO治疗髋关节发育不良时表现出积极的结果，尽管这些患者可能被选择为无至轻微的骨关节炎，高功能状态，和良好的健康。对于40岁以上无髋关节关节炎的髋关节发育不良患者，应考虑使用PAO。尽管我们建议非常有选择性的适应症。证据等级：II。
■审查是根据系统审查和荟萃分析（PRISMA）的首选报告项目指南进行的。搜索的数据库包括PubMed,OVIDMedline,Scopus,Embase,科克伦图书馆,和临床试验。根据预定的纳入和排除标准筛选研究。
■本系统综述包括5项研究。注册年份为1990-2013年。总的来说,有335髋，平均年龄在43.5-47.2岁之间。平均随访4-10.8年。大多数接受髋关节保留的患者患有Tonnis骨关节炎0-1级。有矛盾的证据表明，与<40岁相比，>40岁的患者表现更好还是更差；尽管，>40岁组的大多数患者在PAO后有良好的预后。根据研究，PAO生存率为67-100％。根据研究，并发症的范围为2-36%的病例；尽管，这些并发症均无持久影响.
■40岁以上的患者在使用PAO治疗髋关节发育不良时表现出积极的结果，尽管这些患者可能被选择为无至轻微的骨关节炎，高功能状态，和良好的健康。对于40岁以上无髋关节关节炎的髋关节发育不良患者，应考虑使用PAO。尽管我们建议非常有选择性的适应症。证据等级：II。
