Clinical Orthopaedics and Related Research®最新文献

{"title":"CORR Insights®: What Are the Sex-based Differences of Acetabular Coverage Features in Hip Dysplasia?","authors":"Yusuke Kohno","doi":"10.1097/CORR.0000000000003192","DOIUrl":"10.1097/CORR.0000000000003192","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1984-1986"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Spotlight/Take 5: A Brief Mind-body Intervention Is Feasible and May Prevent Persistent Pain After Acute Orthopaedic Traumas: A Randomized Controlled Trial.","authors":"Seth S Leopold","doi":"10.1097/corr.0000000000003256","DOIUrl":"https://doi.org/10.1097/corr.0000000000003256","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"5 1","pages":"1919-1922"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ArtiFacts: The Emperor's Muscle Man.","authors":"Andreas Leithner, Christiane Druml, Herwig Czech","doi":"10.1097/CORR.0000000000003264","DOIUrl":"https://doi.org/10.1097/CORR.0000000000003264","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":"482 11","pages":"1951-1953"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Ocular Safety in Orthopaedics Overlooked? A Systematic Review of Annual Ocular Radiation Exposure and Protective Measures.","authors":"Keith E Arnold, Victoria Whitmore, Christian J Hecht, Joshua R Porto, Atul F Kamath","doi":"10.1097/CORR.0000000000003172","DOIUrl":"10.1097/CORR.0000000000003172","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative fluoroscopy is increasingly common in orthopaedics, although recent guidelines have reduced the maximum recommended exposure to 20 mSv annually. A systematic review of the literature was conducted to comprehensively assess current adherence to exposure guidelines, identify practice settings at increased risk for exposure, and determine the best practices and personal protective equipment for ocular radiation risk mitigation.</p><p><strong>Questions/purposes: </strong>In this systematic review we asked: (1) Is the annual amount of eye irradiation received by orthopaedic surgeons below the recommended limit of 20 mSv? (2) What is the effectiveness of leaded glasses in reducing the eye's exposure to radiation? (3) Which imaging setups and operative techniques reduce ocular irradiation?</p><p><strong>Methods: </strong>PubMed, Medline, EBSCOhost, and Google Scholar were queried on September 28, 2023, to identify studies assessing intraoperative ocular radiation exposure among orthopaedic surgeons. Studies that measured radiation in or around the eye (such as the bridge of the nose or eyebrows) during orthopaedic procedures were included. Exclusion criteria were duplicate studies, studies that only estimated eye radiation based on the radiation dose recorded at parts of the body distant from the eyes, nonoriginal research, case reports, and articles without full-text English versions available. A total of 393 unique articles were retrieved, and after title, abstract, and full-text screening, 23 dosimetry studies were included, comprising 12 prospective observational studies, 7 phantom models, 1 cadaver model, 2 observational studies, and 1 randomized control trial. Risk of bias was determined via the Methodological Index for Nonrandomized Studies (MINORS) tool. Study quality was generally good to excellent, with noncomparative studies having a mean MINORS score of 14 ± 0 of 16 and comparative studies achieving a mean score of 19 ± 1 of 24, with higher scores representing better study quality. Due to extensive heterogeneity in study design, a meta-analysis was not conducted, with the results rather presented as a narrative summary of key findings.</p><p><strong>Results: </strong>The vast majority of surgeons conducting a variety of orthopaedic and traumatologic procedures were not exposed to a hazardous level of eye irradiation annually, but surgeons who perform a high volume of fluoroscopy-intensive procedures may exceed guidelines. Leaded eyeglasses reduced eye radiation by about 90%, with sport wrap-around glasses offering better shielding than alternatives, although leaded glasses overall were largely underutilized. Positioning mini C-arms in the standard vertical configuration was shown to provide up to a 13-fold decrease in radiation exposure compared with inverted configuration, while standing perpendicular to the fluoroscope further reduced eye irradiation.</p><p><strong>Conclusion: </strong>We foun","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1954-1967"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Brief Mind-body Intervention Is Feasible and May Prevent Persistent Pain After Acute Orthopaedic Traumas: A Randomized Controlled Trial.","authors":"Ana-Maria Vranceanu, Kate N Jochimsen, Julie R Brewer, Ellie A Briskin, Robert A Parker, Eric A Macklin, David Ring, Cale Jacobs, Thuan Ly, Kristin R Archer, Caitlin E W Conley, Mitchel Harris, Paul E Matuszewski, William T Obremskey, David Laverty, Jafar Bakhshaie","doi":"10.1097/CORR.0000000000003111","DOIUrl":"10.1097/CORR.0000000000003111","url":null,"abstract":"<p><strong>Background: </strong>Approximately 20% to 50% of patients develop persistent pain after traumatic orthopaedic injuries. Psychosocial factors are an important predictor of persistent pain; however, there are no evidence-based, mind-body interventions to prevent persistent pain for this patient population.</p><p><strong>Questions/purposes: </strong>(1) Does the Toolkit for Optimal Recovery after Injury (TOR) achieve a priori feasibility benchmarks in a multisite randomized control trial (RCT)? (2) Does TOR demonstrate a preliminary effect in improving pain, as well as physical and emotional function?</p><p><strong>Methods: </strong>This pilot RCT of TOR versus a minimally enhanced usual care comparison group (MEUC) was conducted among 195 adults with an acute orthopaedic traumatic injury at risk for persistent pain at four geographically diverse Level 1 trauma centers between October 2021 to August 2023. Fifty percent (97 of 195) of participants were randomized to TOR (mean age 43 ± 17 years; 67% [65 of 97] women) and 50% (98) to MEUC (mean age 45 ± 16 years; 67% [66 of 98] women). In TOR, 24% (23 of 97) of patients were lost to follow-up, whereas in the MEUC, 17% (17 of 98) were lost. At 4 weeks, 78% (76 of 97) of patients in TOR and 95% (93 of 98) in the MEUC completed the assessments; by 12 weeks, 76% (74 of 97) of patients in TOR and 83% (81 of 98) in the MEUC completed the assessments (all participants were still included in the analysis consistent with an intention-to-treat approach). The TOR has four weekly video-administered sessions that teach pain coping skills. The MEUC is an educational pamphlet. Both were delivered in addition to usual care. Primary outcomes were feasibility of recruitment (the percentage of patients who met study criteria and enrolled) and data collection, appropriateness of treatment (the percent of participants in TOR who score above the midpoint on the Credibility and Expectancy Scale), acceptability (the percentage of patients in TOR who attend at least three of four sessions), and treatment satisfaction (the percent of participants in TOR who score above the midpoint on the Client Satisfaction Scale). Secondary outcomes included additional feasibility (including collecting data on narcotics and rescue medications and adverse events), fidelity (whether the intervention was delivered as planned) and acceptability metrics (patients and staff), pain (numeric rating scale), physical function (Short Musculoskeletal Function Assessment questionnaire [SMFA], PROMIS), emotional function (PTSD [PTSD Checklist], depression [Center for Epidemiologic Study of Depression]), and intervention targets (pain catastrophizing, pain anxiety, coping, and mindfulness). Assessments occurred at baseline, 4 and 12 weeks.</p><p><strong>Results: </strong>Several outcomes exceeded a priori benchmarks: feasibility of recruitment (89% [210 of 235] of eligible participants consented), appropriateness (TOR: 73% [66 of 90] scored > mid","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1923-1937"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CORR Insights®: Is a Three-component Video-based Version of the Foot Posture Index Valid for Assessing Pediatric Patients With Orthopaedic and Neurologic Foot Conditions?","authors":"Khaled M Emara","doi":"10.1097/CORR.0000000000003134","DOIUrl":"10.1097/CORR.0000000000003134","url":null,"abstract":"","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2072-2074"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Open and Arthroscopic Grafting for Scaphoid Nonunion: Is There Truly a Noticeable Difference?","authors":"Ebubekir Eravsar, Ali Özdemir, Mehmet A Acar","doi":"10.1097/CORR.0000000000003145","DOIUrl":"10.1097/CORR.0000000000003145","url":null,"abstract":"<p><strong>Background: </strong>Scaphoid nonunion remains a challenging injury with no clear consensus on treatment. Surgical options, such as bone grafting procedures, are available for the treatment of scaphoid nonunions. While open grafting provides direct visualization, it is theoretically believed to lead to several problems due to the complex ligamentous structure responsible for wrist stability and challenges in the vascular supply of the scaphoid. On the other hand, despite its technical challenges, arthroscopic grafting is thought to avoid complications by preserving surrounding tissues.</p><p><strong>Questions/purposes: </strong>(1) Do patients undergoing bone grafting via arthroscopy for scaphoid nonunion report better function than patients undergoing an open procedure? (2) Do patients undergoing bone grafting via arthroscopy for scaphoid nonunion demonstrate better objective outcomes, such as ROM, extremity strength, and bony union?</p><p><strong>Methods: </strong>Between January 2012 and January 2022, we operated on 141 patients with scaphoid nonunion. The following patients were excluded from this study: 33 patients with scaphoid nonunion advanced collapse and arthritis, 18 patients with proximal pole fractures, 5 patients with previous surgeries, 16 patients with avascular necrosis, and 8 patients with the radius used as a graft source. In total, 28 patients underwent open grafting, and 33 patients underwent arthroscopic grafting; for both groups, the iliac crest was used as the graft source. Two patients with nonunion were observed in each treatment group, and they were excluded from the study. Results from the remaining 26 patients treated with open grafting and 31 patients treated with arthroscopic grafting (totaling 57 patients) were analyzed. The decision to treat patients with open or arthroscopic methods was not based on a particular reason. In our clinic, we initially preferred open grafting for treating nonunion of the scaphoid. Subsequently, we began to prefer arthroscopic methods for the treatment of these injuries. Twenty patients in the arthroscopic group had additional ligamentous injuries, which were simultaneously treated arthroscopically. All patients in both groups had at least 1 year of follow-up, but 48% of patients treated arthroscopically and 42% of those treated with open approaches were lost before 2 years of follow-up. The remaining patients had follow-up periods longer than 24 months. Our primary analysis was performed at 1 year, and we did a secondary analysis at 2 years. We compared the Patient-Rated Wrist Evaluation (PRWE), QuickDASH, and VAS scores of the patients. We also compared ROM and grip and pinch strength in patients' contralateral wrists. We used predefined, evidence-based thresholds for the minimum clinically important differences for these outcome measures.</p><p><strong>Results: </strong>According to the 1-year functional analysis, we found no clinically important difference between the op","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2030-2038"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is a Three-component Video-based Version of the Foot Posture Index Valid for Assessing Pediatric Patients With Orthopaedic and Neurologic Foot Conditions?","authors":"Susan A Rethlefsen, Sylvia Ounpuu, Jennifer Rodriguez-MacClintic, Alison Hanson, Eva M Ciccodicola, Kristan A Pierz, Tishya A L Wren","doi":"10.1097/CORR.0000000000003110","DOIUrl":"10.1097/CORR.0000000000003110","url":null,"abstract":"<p><strong>Background: </strong>The Foot Posture Index-6 (FPI6) is an assessment of foot position that can be useful for patients with orthopaedic complaints. The FPI6 rates six components of foot position from -2 to +2, resulting in a total score on a continuum between -12 (severe cavus or supination) to +12 (severe planus or pronation). The subscores are ratings made by the examiner and are subjective assessments of deformity severity. The FPI6 requires palpation of bony structures around the foot and therefore must be administered live during physical examination. Because it is sometimes impractical to perform these assessments live, such as for retrospective research, a valid and reliable video-based tool would be very useful.</p><p><strong>Questions/purposes: </strong>This study examines a version of the FPI using three of the original six components to determine: (1) Are scores from the three-component version of the FPI (FPI3) associated with those from the original six-component version (FPI6)? (2) Is the three-component FPI3 as reliable as the original six-component FPI6? (3) Are FPI3 assessments done retrospectively from video as reliable as those done live?</p><p><strong>Methods: </strong>A retrospective group of 155 participants (106 males; mean age 13 ± 4 years) was studied. All had undergone gait analysis including videotaping and in-person assessment using the FPI6. Ratings for three components (calcaneus inversion/eversion, medial arch congruence, and forefoot abduction/adduction) were extracted yielding an FPI3 score ranging from -6 to +6. The other three components of the FPI6 (talar head palpation, curves above and below the lateral malleolus, talonavicular joint bulge) were excluded from the FPI3. FPI6 and FPI3 scores and side-to-side asymmetry were compared for all participants and for diagnosis subgroups (cerebral palsy and Charcot-Marie-Tooth disease) using a Pearson correlation. Agreement for foot posture categorization between the FPI6 and FPI3 was assessed using weighted kappa. Intra- and interrater reliability of live and video-based assessments for the FPI3 and its components were examined using intraclass correlation coefficients (ICCs) and Bland-Altman analysis.</p><p><strong>Results: </strong>Scores from the FPI3 and FPI6 are highly associated with each other, suggesting the FPI3 is an adequate substitute for the FPI6. FPI6 and FPI3 scores (r = 0.98) and asymmetry (r = 0.96) were highly correlated overall and within the cerebral palsy (r = 0.98 for scores; r = 0.98 for asymmetry) and Charcot-Marie-Tooth (r = 0.96 for scores; r = 0.90 for asymmetry) subgroups (all p < 0.001). Agreement between the FPI6 and FPI3 was high for foot posture categorization (weighted agreement = 95%, weighted κ = 0.88; p < 0.001). Interrater reliability for live ratings was similar for FPI3 and FPI6 and high for both measures (ICC = 0.95 for FPI6 and 0.94 for FPI3; both p < 0.001). High reliability was seen in video versus live ratings for","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2063-2071"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteotomy Site Venting Enhances Femoral Bone Consolidation With Magnetic Intramedullary Lengthening Nails.","authors":"Roy Gigi, Yehuda Weil, Eyal Amar, Amit Sigal, Dror Ovadia, John E Herzenberg, Eitan Segev","doi":"10.1097/CORR.0000000000003119","DOIUrl":"10.1097/CORR.0000000000003119","url":null,"abstract":"<p><strong>Background: </strong>Magnetic intramedullary lengthening nailing has demonstrated benefits over external fixation devices for femoral bone lengthening. These include avoiding uncomfortable external fixation and associated pin site infections, scarring, and inhibition of muscle or joint function. Despite this, little has changed in the field of biologically enhanced bone regeneration. Venting the femoral intramedullary canal at the osteotomy site before reaming creates egress for bone marrow during reaming. The reamings that are extruded from vent holes may function as a prepositioned bone graft at the distraction gap. The relationship between venting and the consolidation of regenerating bone remains unclear.</p><p><strong>Questions/purposes: </strong>(1) Do bone marrow reamings extruded through venting holes enhance the quality of bone regeneration and improve healing indices and consolidation times? (2) Is venting associated with a higher proportion of complications than nonventing?</p><p><strong>Methods: </strong>We performed a retrospective study of femoral lengthening performed at one hospital from December 2012 to February 2022 using a magnetic intramedullary lengthening nail with or without venting at the osteotomy site before reaming. This was a generally sequential series, in which the study groups were assembled as follows: Venting was performed between July 2012 and August 2016 and again from November 2021 onward. Nonventing was used between October 2016 and October 2021 because the senior author opted to create drill holes after the reaming procedure to avoid commitment to the osteotomy level before completing the reaming procedure. Outcomes were evaluated based on bone healing time, time to achieve full weightbearing, and complications. Sixty-one femoral lengthening procedures were studied (in 33 male and 28 female patients); two patients were excluded because of implant breakage. The mean age was 17 ± 5 years. The mean amount of lengthening was 55 ± 13 mm in the venting group and 48 ± 16 mm in the nonventing group (mean difference 7 ± 21 [95% CI 2 to 12]; p = 0.07). The healing index was defined as the time (in days) required for three cortices to bridge with new bone formation divided by the length (in cm) lengthened during the clinical protocol. This index signifies the bone formation rate achieved under the specific conditions of the protocol. Full weightbearing was allowed upon bridging the regenerated gap on three sides. Consolidation time was defined as the total number of days from the completion of the lengthening phase until adequate bone union (all three cortices healed) was achieved and full weightbearing was permitted. This time frame represents the entire healing process after the lengthening is complete divided by the amount of lengthening achieved (in cm). Patient follow-up was conducted meticulously at our institution, and we adhered to a precise schedule, occurring every 2 weeks during the distraction pha","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"2075-2085"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Prior Nonoperative or Operative Treatment of Dysplasia of the Hip Associated With Poorer Results of Periacetabular Osteotomy?","authors":"Zhendong Zhang, Nannan Cheng, Haigang Jia, Hui Cheng, Yue Song, Ningtao Ren, Yong Li, Dianzhong Luo, Hong Zhang","doi":"10.1097/CORR.0000000000003150","DOIUrl":"10.1097/CORR.0000000000003150","url":null,"abstract":"<p><strong>Background: </strong>Understanding the implications of either nonoperative or operative treatment of developmental dysplasia of the hip (DDH) performed before periacetabular osteotomy (PAO) is critical to counseling patients and their families. There are limited studies, however, on PAO for the treatment of residual DDH after surgical intervention during childhood, and even less information about PAO after prior nonoperative treatment.</p><p><strong>Questions/purposes: </strong>We analyzed patients who had undergone PAO for DDH and asked: Did patients with prior childhood treatment (either operative or nonoperative) (1) improve less in modified Harris hip score (mHHS), 12-item International Hip Outcome Tool (iHOT-12) score, or WOMAC score; (2) demonstrate more severe preoperative deformities; and (3) receive less complete radiographic correction and have more frequent complications than did patients whose hips had not undergone prior treatment? We also asked: (4) Were there subgroup differences among patients with DDH treated nonoperatively versus operatively before PAO in these same functional and radiographic parameters?</p><p><strong>Methods: </strong>Between January 2011 and December 2020, a total of 90 PAOs were performed in 82 patients who had prior surgical or nonsurgical treatment. Of those, 3 patients (3 hips) with neuromuscular diseases were excluded, 4 patients (5 hips) were excluded for having received treatment after childhood, 7 hips that had undergone bilateral PAOs were excluded, and another 4 patients (4 hips) were lost to follow-up before the minimum study period of 2 years, leaving 71 patients (71 hips) for analysis (the previous treatment group). Among these, 32 patients had a history of previous surgery (the previous surgery group), and 39 patients had prior nonsurgical treatment (such as a Pavlik harness, closed reduction, spica casting) (the previous nonoperative group). During the same period, 1109 PAOs were performed in 956 patients who had no history of previous hip treatment. Following a 1:2 ratio, 142 patients (142 hips) were selected as the control group by matching for age (within 2 years difference), year of surgery (same year), and follow-up time (within 1-year difference). The patient characteristics for both the previous treatment group and the control group exhibited comparability, with mean ± SD follow-up durations of 49 ± 23 months and 48 ± 19 months, respectively. Within the previous 5 years, 3 patients (8%) in the previous nonoperative group, 4 patients (13%) in the previous surgery group, and 15 patients (11%) in the control group had not attended follow-up visits. We compared hip function and radiographic results between the two groups and performed a subgroup analysis between the previous surgery group and the previous nonoperative group. Hip function was assessed using the mHHS questionnaire, the WOMAC, and the iHOT-12 with attention to the minimum clinically important differences of these too","PeriodicalId":10404,"journal":{"name":"Clinical Orthopaedics and Related Research®","volume":" ","pages":"1987-1996"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11469904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}