Does Participation in Sports Affect Osteoarthritic Progression After Periacetabular Osteotomy?
Does Participation in Sports Affect Osteoarthritic Progression After Periacetabular Osteotomy?
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DOI：
10.1177/0363546517707942
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发表时间：
2017-09-01
影响因子：
4.8
通讯作者：
Nakashima, Yasuharu
中科院分区：
文献类型：
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作者：
Hara, Daisuke;Hamai, Satoshi;Nakashima, Yasuharu
背景：髋臼周围截骨术（PAO）是治疗症状性髋臼发育不良的有效方法。然而，术后参加体育活动是否会导致这些患者骨关节炎（OA）Kelling-Lawrence（KL）分级的进展尚不清楚。目的：调查（1）PAO前后参加体育活动的情况和（2）术后参加体育活动是否会导致KL分级的进展。研究设计：病例对照研究;证据等级，3.方法：作者回顾性审查了1998年至2011年期间因术前KL 1级或2级症状性髋臼发育不良接受PAO的161例患者（183例髋关节）的数据。手术时的平均年龄为42.0 ± 10.9岁（范围：12-64岁），平均随访时间为100个月（范围：13-180个月）。数据包括参与体育活动、加州大学洛杉矶分校（UCLA）活动量表评分、手术时年龄、体重指数、随访时间、发育性髋关节脱位治疗史、Merle d 'Aubigne-Postel评分、Oxford髋关节评分、中心边缘角和KL分级。单因素和多因素分析，以确定哪些因素与进展到KL 3级或4级后PAO。结果：参加体育活动的患者人数显着增加，从术前50（31.1%），术后89（55.3%）。平均UCLA评分从术前4.7 ± 2.1显著增加至术后5.5 ± 2.0。16个髋关节的KL分级进展为3级或4级，包括4个髋关节，接受了全髋关节置换术。KL 1级或2级髋关节与KL 3级或4级髋关节之间的术后运动参与率（分别为89例髋关节[53.3%] vs 11例髋关节[68.8%]; P = 0.24）和UCLA评分（分别为5.6 +/- 2.0 vs 5.1 +/- 2.0; P = 0.30）无显著差异。多因素分析显示，包括术后参加体育活动在内的所有因素均与KL 3级或4级的进展无显著相关性。结论：PAO术后参加体育活动对中期随访时KL分级的进展无显著负面影响。
Background: Periacetabular osteotomy (PAO) is an effective treatment for symptomatic acetabular dysplasia. However, whether postoperative participation in sports leads to progression of the Kellgren-Lawrence (KL) grade of osteoarthritis (OA) in these patients is unclear.Purpose: To investigate (1) participation in sports before and after PAO and (2) whether postoperative participation in sports leads to progression of the KL grade.Study Design: Case-control study; Level of evidence, 3.Methods: The authors retrospectively reviewed data on 161 patients (183 hips) who underwent PAO for symptomatic acetabular dysplasia with preoperative KL grade 1 or 2 between 1998 and 2011. The mean age at the time of surgery was 42.0 +/- 10.9 years (range, 12-64 years), and the mean follow-up duration was 100 months (range, 13-180 months). Data included participation in sports, the University of California, Los Angeles (UCLA) activity scale score, age at the time of surgery, body mass index, follow-up duration, history of treatment for developmental hip dislocations, Merle d'Aubigne-Postel score, Oxford Hip Score, center-edge angle, and KL grade. Univariate and multivariate analyses were applied to determine which factors were associated with progression to KL grade 3 or 4 after PAO.Results: The number of patients who participated in sports significantly increased from 50 (31.1%) preoperatively to 89 (55.3%) postoperatively. The mean UCLA score significantly increased from 4.7 +/- 2.1 preoperatively to 5.5 +/- 2.0 postoperatively. The KL grade progressed to grade 3 or 4 in 16 hips, including 4 hips that underwent conversion to total hip arthroplasty. No significant differences were found in postoperative participation in sports (89 hips [53.3%] vs 11 hips [68.8%], respectively; P = .24) and the UCLA score (5.6 +/- 2.0 vs 5.1 +/- 2.0, respectively; P = .30) between hips with KL grade 1 or 2 and KL grade 3 or 4. A multivariate analysis revealed that no factors, including postoperative participation in sports, were significantly associated with progression to KL grade 3 or 4.Conclusion: Postoperative participation in sports after PAO did not significantly and negatively influence progression of the KL grade at midterm follow-up.