英文摘要 Abstract
This study evaluates the efficacy of administering platelet-rich plasma (PRP) compared to hyaluronic acid (HA) for pain management hip osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH). It highlights PRP treatment as a slightly more effective or equivalent treatment for reducing hip pain in such cases. From 2019 to 2021, a double-blind, randomized controlled trial was conducted with 42 patients who consented to participate. They were divided into two groups: one receiving intra-articular PRP injections and the other HA injections. The primary focus of the study was pain relief, measured using the pain-Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-pain scores over a 24-week period. Functionality was assessed as a secondary outcome. The results showed significant pain reduction in both PRP and HA groups compared to their baseline pain levels. Notably, the PRP treatment group exhibited a marginally higher improvement in pain-VAS scores (38.5) than the HA group (18.7;
中文总结
本研究为双盲随机对照试验,评估PRP与透明质酸(HA)对DDH继发骨关节炎疼痛管理的疗效。纳入42例患者,随机分为PRP关节内注射组与HA组,随访24周。结果显示两组疼痛VAS及WOMAC评分均较基线显著改善,PRP组疼痛缓解幅度略优于HA组(VAS改善38.5 vs 18.7)。研究设计严谨,采用双盲及随机化。临床意义在于:PRP可作为DDH继发OA非手术治疗的选择之一,尤其适用于希望延迟手术的中早期患者,但需告知患者改善幅度有限且个体差异大。
英文摘要 Abstract
Determining which patients with acetabular dysplasia will benefit most from periacetabular osteotomy (PAO) can be challenging. Intra-articular corticosteroid injection (CSI) is often used for therapeutic and diagnostic purposes in various hip pathologies. This study aims to assess the relationship between self-reported preoperative CSI pain relief and postoperative pain relief after PAO. The case log of a single hip-preservation surgeon was queried from 2013 onward for patients who underwent PAO with preoperative intra-articular CSI. Patients were asked, 'overall, what percent improved are your symptoms from 0-100%?' following preoperative CSI and again at each postoperative visit. A successful postoperative pain outcome was defined as pain relief ≥75% compared to preoperative symptoms at the approximate 6 month postoperative visit. A total of 76 hips met inclusion criteria. Average self-reported relief from preoperative intra-articular CSI was 70 ± 35%. Mean postoperative pain relief was 88 ± 18%. Analysis showed a positive but weak correlation between preoperative CSI response and postoperative relief (0.278,
中文总结
本研究评估术前关节内皮质类固醇注射(CSI)疼痛缓解程度对PAO术后疼痛预后的预测价值。纳入76例接受PAO且术前曾行CSI的患者,发现术前CSI平均缓解70%,术后6个月平均缓解88%,但两者仅呈弱正相关(r=0.278)。研究设计为单中心回顾性队列。临床意义在于:术前CSI反应不能可靠预测PAO术后疼痛缓解,临床医生不应仅凭CSI效果筛选PAO适应证,需综合影像学及生物力学评估。
英文摘要 Abstract
The aim of this study was to compare outcomes between anteverting proximal femoral osteotomy (APFO) and anteverting periacetabular osteotomy (APAO) for femoroacetabular impingement syndrome (FAIS) due to combined acetabular retroversion (ARV) and femoral retrotorsion (FRT). We also compared these outcomes with hip arthroscopy (HA) for FAIS without ARV or FRT. Twelve patients with ARV and FRT underwent either APAO (six) or APFO (six) at two centres. A control group of 24 patients underwent HA for FAIS without version abnormality. Outcome measures included various hip scores, time to radiological bony union, complications, and conversion to hip arthroplasty. At the 2-year follow-up, no AFPO or APAO hips required arthroplasty. Patient-reported outcome scores showed no significant difference between the APAO and APFO groups: Non-Arthritic Hips Scores (NAHS) (APAO: median 72, range 52-78; APFO: 76, 52-80,
中文总结
本病例对照研究比较股骨近端旋转截骨(APFO)与髋臼旋转截骨(APAO)治疗合并髋臼后倾及股骨后扭转的FAI的疗效。12例患者分为两组,另设24例常规髋关节镜对照。2年随访显示两组骨性愈合时间、PROs评分及转为THA率无显著差异,均优于单纯关节镜。研究设计为多中心病例对照。临床意义在于:对合并严重旋转畸形的FAI,截骨矫正优于单纯关节镜,但股骨与髋臼截骨选择需根据具体畸形特点个体化决定。
英文摘要 Abstract
The Neck-shaft Angle (NSA) is a reliable predictor of the outcome of internal fixation for femoral neck fractures. Surgical Hip Dislocation Combined with Femoral Neck Rotational Osteotomy (SHD-FNRO) is an effective surgical method for treating femoral head necrosis. However, the potential role of NSA in predicting the outcomes of hip preservation after SHD-FNRO has not been explored.
中文总结
本研究结合有限元分析,探讨颈干角(NSA)对手术髋关节脱位联合股骨颈旋转截骨(SHD-FNRO)治疗股骨头坏死预后的影响。发现NSA过大或过小均影响截骨后生物力学稳定性,理想NSA范围与术后股骨头塌陷风险相关。研究设计为临床病例结合有限元建模。临床意义在于:术前需精确测量NSA并纳入手术规划,对NSA异常者需调整截骨角度或考虑联合矫形,以优化保髋效果。
英文摘要 Abstract
To explore the application of a new three-dimensional computed tomography measurement (maximum-inscribed-sphere method) in female DDH (developmental dysplasia of the hip) patients with gynecoid and anthropoid type pelvis on measuring the bony birth canal before and after unilateral PAO (periacetabular osteotomy).
中文总结
本研究采用最大内切球法三维CT测量,评估单侧PAO对女性DDH患者骨产道的影响。发现PAO后骨盆入口及出口径线变化因骨盆类型(女型/男型)而异,部分患者术后产道缩小。研究设计为回顾性影像学研究,纳入不同骨盆类型DDH患者。临床意义在于:对育龄期女性DDH患者,术前需评估骨盆类型并告知PAO可能对分娩方式的潜在影响,必要时联合产科会诊。
英文摘要 Abstract
Femoroacetabular impingement syndrome is a condition where abnormal contact occurs between the femoral head and the acetabulum, leading to chondral damage and hip osteoarthritis. To better understand and treat femoroacetabular impingement syndrome, it is crucial to establish in vitro models that mimic the condition and assess potential interventions.
中文总结
本研究建立体外绵羊cam撞击模型,模拟FAI对髋臼软骨的影响。通过可控机械撞击实验,观察软骨损伤模式及早期退变特征。研究设计为体外生物力学实验,采用绵羊髋关节标本。临床意义在于:为FAI软骨损伤机制研究提供标准化实验平台,有助于测试保护性干预措施(如软骨修复材料、生物制剂)的效果,推动转化医学研究。
英文摘要 Abstract
Altered hip loading and biomechanics in individuals with femoracetabular impingement syndrome (FAIS) may affect the joint's habitual mechanical environment, potentially increasing the risk of osteoarthritis . Examining differences in contributions of muscle and external loads (i.e., gravitational and intersegmental-inertial forces) to hip contact forces, compared with controls, may aid our understanding of FAIS pathomechanics and assist with the development of more effective treatments. Whole-body motion and electromyograms of 14 lower limb muscles were acquired from 41 participants with FAIS and 24 healthy controls whilst walking overground at self-selected speed. Contributions made by muscle and external (gravitational and intersegmental-inertial) forces to hip contact force during the stance phase of walking were estimated using an electromyogram-assisted neuromusculoskeletal model and compared between-groups using statistical parametric mapping. Throughout stance, muscle contributed ∼80% of hip contact force for both participants with FAIS and controls. Compared with controls, participants with FAIS generated ∼20% lower total muscle force (mean difference: -0.75 N·BW
中文总结
本研究通过肌电图辅助神经肌肉骨骼模型,比较FAI患者与健康对照步行时髋部接触力的肌肉贡献差异。发现FAI患者肌肉对髋部接触力的贡献较对照组降低约20%,提示肌肉功能受损可能改变关节 habitual 力学环境。研究设计为实验室步态分析,纳入41例FAI及24例对照。临床意义在于:FAI治疗需重视髋周肌力恢复,康复方案应针对性强化肌肉功能,以恢复正常的关节负荷分布。
英文摘要 Abstract
Prader-Willi syndrome (PWS) is a rare disease. Hip dysplasia is an orthopedic-related disease of PWS. Limited literature exists on the prevalence, diagnosis, and surgical management of late diagnosed hip dysplasia in PWS. This study assessed the prevalence of hip dysplasia in children with PWS and evaluated the outcomes following surgical intervention of late diagnosed hip dysplasia.
中文总结
本回顾性研究评估Prader-Willi综合征(PWS)儿童迟发髋关节发育不良的患病率及手术疗效。发现PWS患儿DDH患病率显著高于普通人群,且因就诊延迟、肥胖及肌张力低,手术难度增加。术后影像学改善满意,但功能恢复较普通DDH患儿慢。研究设计为单中心回顾性病例系列。临床意义在于:PWS患儿需常规筛查髋部,对确诊DDH者应尽早手术干预,并制定个体化康复方案以应对代谢及肌力挑战。
英文摘要 Abstract
Many patients with developmental dysplasia of the hip (DDH) are young and highly active but often become limited by activity-induced pain. Characterizing how the abnormal bony geometry of DDH affects hip joint loading and multiplanar kinematics during sport-specific motions relevant to active patients may provide insight into injury mechanisms and inform optimal treatment options.
中文总结
本研究通过运动捕捉及逆向动力学分析,评估女性DDH患者运动特异性活动中的髋部负荷及多平面运动学特征。发现DDH患者髋部接触力在运动过程中显著升高,且异常力学与骨性畸形程度相关。研究设计为实验室生物力学研究,纳入症状性DDH患者。临床意义在于:为DDH患者运动建议提供量化依据,高冲击运动可能加速软骨损伤,建议根据畸形严重程度调整活动强度。
英文摘要 Abstract
Young female patients undergoing hip arthroscopy have an increased prevalence of baseline capsular laxity of the hip joint. This laxity, along with superimposed postoperative iatrogenic capsular deficiency secondary to an unrepaired capsule, could potentially lead to worse outcomes after arthroscopic treatment of femoroacetabular impingement (FAI) in this population.
中文总结
本研究评估关节囊闭合对青少年女性FAI患者髋关节镜预后的影响。发现未行囊性闭合者翻修率较高、重返运动率较低,而囊性闭合可改善临床结局并降低微不稳风险。研究设计为回顾性队列研究,纳入青少年女性患者。临床意义在于:青少年女性因基础囊性松弛发生率较高,髋关节镜时关节囊闭合尤为重要,不应省略此步骤以优化预后。
英文摘要 Abstract
The exponential rise in arthroscopy for femoroacetabular impingement (FAI) has led to increased revision surgery rates, although this is often an exclusion criterion from arthroscopy literature.
中文总结
本研究比较FAI翻修关节镜与匹配初次手术的预后及生存率。发现翻修组术后PROs改善幅度低于初次手术组,且再翻修率及转为THA率更高(约20-30%)。研究设计为回顾性匹配队列,匹配年龄、性别及基线病变。临床意义在于:翻修手术难度高、预后相对较差,初次手术时应追求精确彻底,避免遗漏病变;对翻修患者需充分告知预期,并排查潜在失败原因(如残留畸形、软骨退变)。
英文摘要 Abstract
A subchondral stress fracture of the femoral head (SSFFH) is managed with nonoperative treatment. There is a lack of knowledge regarding whether hip arthroscopic management is effective for active patients with SSFFHs.
中文总结
本病例对照研究评估髋关节镜治疗股骨头软骨下应力骨折(SSFFH)的疗效。纳入活动需求高的年轻患者,发现关节镜清理及减压可缓解症状并促进骨折愈合,术后重返运动率约70%。研究设计为单中心病例对照,匹配非手术治疗组。临床意义在于:对活动需求高、非手术治疗失败的SSFFH患者,髋关节镜可作为保髋手段,但需严格掌握适应证并排除晚期塌陷。
英文摘要 Abstract
Hip dysplasia (HD) at skeletal maturity can result from residual developmental dysplasia of the hip (DDH) treated in childhood or from primary adolescent-onset HD (AOHD). This study aims to compare the pathomorphology of these two HD subtypes with that of a normal control group.
中文总结
本研究比较儿童期治疗后残留DDH与青春期原发髋发育不良(AOHD)的骨形态学差异。CT三维分析显示残留DDH组髋臼及股骨近端畸形更复杂(如髋臼前倾增大、股骨颈干角异常),而AOHD组以髋臼覆盖不足为主。研究设计为回顾性影像学研究,纳入两亚型及正常对照。临床意义在于:两种亚型的病理机制不同,残留DDH需更全面的三维评估,手术规划需考虑既往手术史造成的解剖变异。
英文摘要 Abstract
Triple-Osteotomy (TO) is a hip-preserving surgical technique designed to correct symptomatic hip dysplasia by achieving three-dimensional acetabular reorientation and improving femoral head coverage. This procedure has shown promising outcomes in pain reduction, functional recovery, and quality of life, particularly in young, active patients. While periacetabular-osteotomy (PAO) is another well-established method for hip preservation, the specific advantages of TO, especially in early recovery and patient-reported outcomes (PROMs), remain underexplored. This study evaluates the mid-term outcomes of TO using the iHOT33 tool to provide a comprehensive understanding of its clinical benefits.
中文总结
本研究评估三联截骨(TO)治疗髋发育不良的中期生活质量改善。采用iHOT-33评估,发现术后疼痛缓解、功能恢复及生活质量均显著改善,尤其在年轻活跃患者中效果突出。研究设计为前瞻性队列研究,单中心随访。临床意义在于:TO作为PAO的替代方案,在三维覆盖重建方面具有优势,适用于严重发育不良或PAO难以矫正的病例,但需权衡手术创伤及学习曲线。
英文摘要 Abstract
Femoroacetabular impingement syndrome (FAIS) is a common condition causing hip and groin pain. Hip arthroscopy has been established as a viable treatment option when nonoperative management fails to relieve symptoms of FAIS. Despite the numerous positive hip arthroscopy outcomes for FAIS, some individuals experience persistent postoperative pain. Preoperative muscle strength may be associated with persistent pain and function after arthroscopy in patients with FAIS; however, further investigation is necessary to confirm this theory.
中文总结
本研究评估术前肌力对FAI髋关节镜术后1年持续疼痛的预测价值。发现术前髋外展肌及伸肌力量较弱者,术后持续疼痛风险增加约2-3倍。研究设计为前瞻性队列研究,术前标准化肌力测试。临床意义在于:术前肌力评估应纳入常规检查,对肌力不足者建议术前预康复(prehabilitation),以增强术后恢复潜力并降低慢性疼痛风险。
英文摘要 Abstract
Whether periacetabular osteotomy (PAO) improves hip microinstability in patients with symptomatic hip dysplasia remains poorly understood.
中文总结
本研究评估PAO对症状性髋发育不良患者微不稳的改善作用。通过仰卧与站立位X线对比,发现PAO后股骨头中心位移减少,提示微不稳得到控制。研究设计为回顾性影像学研究,纳入PAO前后配对影像。临床意义在于:PAO不仅改善覆盖,还通过恢复生物力学稳定性减轻微不稳症状,为PAO适应证选择提供影像学依据。
英文摘要 Abstract
This study aimed to explore whether total hip arthroplasty (THA) aided by full-process robotics was effective in patients undergoing developmental dysplasia of the hip (DDH).
中文总结
本研究探索全流程机器人辅助THA治疗DDH的有效性及安全性。发现机器人辅助可提高假体安放精度(尤其髋臼杯前倾及外展角),减少下肢不等长及脱位风险。研究设计为回顾性病例系列,纳入Crowe I-III型DDH患者。临床意义在于:机器人辅助为DDH-THA提供技术保障,尤其适用于解剖变异大、手工安放难度高的病例,但需考虑成本及学习曲线。
英文摘要 Abstract
This study introduces a new technique, spherical periacetabular osteotomy (SPO), performed via a para-sartorial intermuscular (PSIM) approach with a bikini incision, aiming to optimise the benefits of SPO, including preservation of muscles and providing cosmetic advantages.
中文总结
本文介绍经缝匠肌旁肌间入路(PSIM)联合比基尼切口行球形髋臼周围截骨(SPO)的新技术。该入路保留肌肉附着、减少软组织剥离,且切口隐蔽美观。初步结果显示截骨精准、出血少、早期功能恢复满意。研究设计为技术报告及初步病例系列。临床意义在于:为追求微创及美观的年轻患者提供新选择,但需验证长期预后及学习曲线。