Sakai Akinori
   Department   Wakamatsu Hospital of the University of Occupational and Environmental Health  Hospital President, Wakamatsu Hospital
   School of Medicine  Orthopedic Surgery, Clinical Medical Sciences
Article types journal article
Language English
Peer review Peer reviewed
Title Clinical and Radiographic Predictors for Worsened Clinical Outcomes After Hip Arthroscopic Labral Preservation and Capsular Closure in Developmental Dysplasia of the Hip.
Journal Formal name:The American journal of sports medicine
Abbreviation:Am J Sports Med
ISSN code:15523365/03635465
Volume, Issue, Page 44(1),28-38頁
Author and coauthor Uchida Soshi, Utsunomiya Hajime, Mori Toshiharu, Taketa Tomonori, Nishikino Shoichi, Nakamura Toshitaka, Sakai Akinori
Publication date 2016/01
Summary BACKGROUND:Patients with developmental dysplasia of the hip (DDH) have a greater risk of acetabular labral tearing and joint instability, which predispose them to developing osteoarthritis. The arthroscopic management of DDH, however, remains controversial.HYPOTHESIS:Specific clinical characteristics and radiographic parameters correlate with and predict a worsened clinical outcome after hip arthroscopic surgery for DDH.STUDY DESIGN:Case control study; Level of evidence, 3.METHODS:Of patients with DDH who underwent an arthroscopic procedure between March 2009 and June 2011, there were 28 hips in 28 patients (6 male and 22 female) that met the inclusion criteria. The mean patient age was 28.4 years. Clinical and radiographic follow-up evaluations up to a minimum of 2 years after surgery were performed for all patients. Failure of the procedure was defined as conversion to subsequent surgery or having a Tönnis osteoarthritis grade of 2 and modified Harris Hip Score (mHHS) that remained <85, and success was defined as patients who did not need subsequent surgery and had an mHHS >85. Univariate analysis and Cox hazard proportional analysis were performed on the 2 subpopulations.RESULTS:There were 9 patients in the failure group (including 3 hips with T nnis grade 2) and 19 patients in the success group. In 22 of 28 patients, the mean mHHS significantly improved from 61.6 ± 18.8 (range, 12.0-85.0) preoperatively to 94.3 ± 7.0 (range, 73.7-100.0) at final follow-up, and the mean Non-Arthritic Hip Score (NAHS) improved from 56.2 ± 13.9 (range, 35.0-81.3) preoperatively to 92.7 ± 9.5 (range, 65.0-100.0) at final follow-up (P < .001, Wilcoxon signed-rank test). Univariate analysis showed that a broken Shenton line was significantly more prevalent in the failure group compared with the success group (8/9 [89%] vs 3/19 [16%] patients, respectively; P < .001). High-grade cartilage delamination (Multicenter Arthroscopy of the Hip Outcomes Research Network [MAHORN] grades 3-
DOI 10.1177/0363546515604667
PMID 26430057