股関節鏡視下手術と寛骨臼骨切り術を併用した股関節形成術における耐久性のある中期成績と有意な改善率
Ady H Kahana-Rojkind1,2,3, Elizabeth G Walsh1, Roger Quesada-Jimenez1
1American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.
Purpose:
To evaluate 5-year outcomes following combined hip arthroscopy and periacetabular osteotomy (PAO) for the treatment of acetabular dysplasia and intra-articular pathology, with a focus on the rates of achieving clinically meaningful outcome thresholds.
Methods:
Minimum 5-year outcome data from a prospectively maintained database were queried to identify patients who underwent concomitant primary hip arthroscopy and PAO between October 2010 and July 2019. Patient-reported outcomes evaluated included the modified Harris Hip Score (mHHS), non-arthritic hip score (NAHS), hip outcome score sport-specific subscale (HOS-SSS), and international hip outcome tool 12 (iHOT12). Clinically meaningful thresholds were also assessed, including minimal clinically important difference (MCID), patient-acceptable symptom state (PASS), and substantial clinical benefit (SCB).
Results:
A total of 32 hips were included in this study. All PROs demonstrated significant improvement from the preoperative baseline to the 5-year follow-up (P < .001). Clinical outcomes remained durable, with no significant decline observed between 2-year and 5-year follow-ups (mHHS P = 0.612; NAHS P = 0.701; iHOT-12 P = 0.284; HOS-SSS P = 0.158). Similarly, achievement rates for MCID, PASS, and SCB thresholds were sustained over time (P = 0.105 to >0.999). Two hips (5.7%) converted to total hip arthroplasty (THA).
Conclusions:
Concomitant hip arthroscopy and PAO are an effective procedure with durable 5-year outcomes. Patients demonstrated sustained improvements and a high rate of clinically meaningful success, supporting the value of this combined approach in appropriately selected cases.
Level Of Evidence:
Level IV: Retrospective therapeutic case series.
