Andrew J Curley, Connor L Luck, Wasim Shihab, Ethan R Ruh, Ashley E Disantis, Michael P McClincy
{"title":"髋臼周围截骨治疗髋发育不良后骨盆倾斜改变吗？","authors":"Andrew J Curley, Connor L Luck, Wasim Shihab, Ethan R Ruh, Ashley E Disantis, Michael P McClincy","doi":"10.1097/BPO.0000000000002870","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to (1) evaluate preoperative pelvic tilt utilizing the sacro-femoral-pubic (SFP) angle on standing pelvic x-rays, and (2) determine if the SFP angle changes after a unilateral or bilateral PAO.</p><p><strong>Methods: </strong>A retrospective review was conducted of PAOs performed by a single hip preservation surgeon from November 2018 to November 2023. Standing x-rays were reviewed at 4 time points: preoperative, subacute postoperative, 6-month follow-up, and 12-month follow-up. Data collected included demographics, lateral center-edge angle (LCEA), Tönnis angle, and sacro-femoral-pubic (SFP) angle (a surrogate metric for pelvic tilt). Linear mixed models and Wilcoxon signed-rank tests were used to evaluate preoperative to postoperative differences in pelvic tilt for the unilateral and bilateral PAO groups, respectively.</p><p><strong>Results: </strong>Seventy-four patients met inclusion criteria, consisting of 53 unilateral and 21 bilateral PAO patients (18.5±4.1 vs. 21.3±5.1 y, 90.6% vs. 95.2% female, LCEA 17.5 deg±6.5 deg vs. 18.0 deg±5.5 deg and 18.0 deg±6.3 deg, respectively). The Average preoperative pelvic tilt, calculated from the SFP angle, for the unilateral and bilateral PAO patients were 9.1 degrees±5.5 degrees and 8.1 degrees±5.6 degrees, respectively. These values increased postoperatively at average 7-week (-0.3 deg±3.4 deg and 1.3 deg±3.7 deg), 6-month (1.1 deg±3.8 deg and 2.7 deg±3.4 deg), and 12-month (1.0 deg±4.1 deg and 2.7 deg±3.0 deg) follow-up. Significant differences in pelvic tilt were observed from preoperative x-rays to 6 months ( P =0.002) and 12 months ( P =0.001) for the bilateral PAO patients, whereas the unilateral group demonstrated similar pelvic tilt at all time points ( P =0.09).</p><p><strong>Conclusion: </strong>Patients undergoing bilateral PAO demonstrated an average increase in pelvic tilt of 2.7 degrees as measured by SFP angle at 6 months and 12 months postoperatively, suggesting a compensatory adaptation after surgery that may have implications in rehabilitation regimens and planned surgical corrections.</p><p><strong>Level of evidence: </strong>Level III-therapeutic study.</p>","PeriodicalId":16945,"journal":{"name":"Journal of Pediatric Orthopaedics","volume":" ","pages":"e318-e323"},"PeriodicalIF":1.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does Pelvic Tilt Change After Periacetabular Osteotomy for Hip Dysplasia?\",\"authors\":\"Andrew J Curley, Connor L Luck, Wasim Shihab, Ethan R Ruh, Ashley E Disantis, Michael P McClincy\",\"doi\":\"10.1097/BPO.0000000000002870\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The purpose of this study was to (1) evaluate preoperative pelvic tilt utilizing the sacro-femoral-pubic (SFP) angle on standing pelvic x-rays, and (2) determine if the SFP angle changes after a unilateral or bilateral PAO.</p><p><strong>Methods: </strong>A retrospective review was conducted of PAOs performed by a single hip preservation surgeon from November 2018 to November 2023. Standing x-rays were reviewed at 4 time points: preoperative, subacute postoperative, 6-month follow-up, and 12-month follow-up. Data collected included demographics, lateral center-edge angle (LCEA), Tönnis angle, and sacro-femoral-pubic (SFP) angle (a surrogate metric for pelvic tilt). Linear mixed models and Wilcoxon signed-rank tests were used to evaluate preoperative to postoperative differences in pelvic tilt for the unilateral and bilateral PAO groups, respectively.</p><p><strong>Results: </strong>Seventy-four patients met inclusion criteria, consisting of 53 unilateral and 21 bilateral PAO patients (18.5±4.1 vs. 21.3±5.1 y, 90.6% vs. 95.2% female, LCEA 17.5 deg±6.5 deg vs. 18.0 deg±5.5 deg and 18.0 deg±6.3 deg, respectively). The Average preoperative pelvic tilt, calculated from the SFP angle, for the unilateral and bilateral PAO patients were 9.1 degrees±5.5 degrees and 8.1 degrees±5.6 degrees, respectively. These values increased postoperatively at average 7-week (-0.3 deg±3.4 deg and 1.3 deg±3.7 deg), 6-month (1.1 deg±3.8 deg and 2.7 deg±3.4 deg), and 12-month (1.0 deg±4.1 deg and 2.7 deg±3.0 deg) follow-up. Significant differences in pelvic tilt were observed from preoperative x-rays to 6 months ( P =0.002) and 12 months ( P =0.001) for the bilateral PAO patients, whereas the unilateral group demonstrated similar pelvic tilt at all time points ( P =0.09).</p><p><strong>Conclusion: </strong>Patients undergoing bilateral PAO demonstrated an average increase in pelvic tilt of 2.7 degrees as measured by SFP angle at 6 months and 12 months postoperatively, suggesting a compensatory adaptation after surgery that may have implications in rehabilitation regimens and planned surgical corrections.</p><p><strong>Level of evidence: </strong>Level III-therapeutic study.</p>\",\"PeriodicalId\":16945,\"journal\":{\"name\":\"Journal of Pediatric Orthopaedics\",\"volume\":\" \",\"pages\":\"e318-e323\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BPO.0000000000002870\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BPO.0000000000002870","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/5 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
背景：本研究的目的是：(1)利用站立骨盆x线片上的骶股耻骨（SFP）角度评估术前骨盆倾斜，(2)确定单侧或双侧PAO后SFP角度是否会改变。方法：回顾性分析2018年11月至2023年11月由一名髋关节保护外科医生进行的PAOs。术前、亚急性术后、6个月随访、12个月随访4个时间点复查站立x线片。收集的数据包括人口统计学、外侧中心边缘角（LCEA）、Tönnis角和骶股耻骨角（SFP）（骨盆倾斜的替代指标）。采用线性混合模型和Wilcoxon符号秩检验分别评估单侧和双侧PAO组术前和术后骨盆倾斜的差异。结果：74例患者符合纳入标准，包括53例单侧PAO患者和21例双侧PAO患者（18.5±4.1 vs 21.3±5.1 y, 90.6% vs 95.2%女性，LCEA分别为17.5°±6.5°vs 18.0°±5.5°和18.0°±6.3°）。根据SFP角度计算，单侧和双侧PAO患者的平均术前骨盆倾斜度分别为9.1度±5.5度和8.1度±5.6度。这些数值在术后平均7周（-0.3°±3.4°和1.3°±3.7°）、6个月（1.1°±3.8°和2.7°±3.4°）和12个月（1.0°±4.1°和2.7°±3.0°）随访时均有所增加。从术前x线到6个月（P=0.002）和12个月（P=0.001），双侧PAO患者的骨盆倾斜有显著差异，而单侧PAO组在所有时间点都表现出相似的骨盆倾斜（P=0.09）。结论：双侧PAO患者在术后6个月和12个月的SFP角度测量显示骨盆倾斜平均增加2.7度，提示术后代偿适应可能对康复方案和计划的手术矫正有影响。证据等级：iii级——治疗性研究。
Does Pelvic Tilt Change After Periacetabular Osteotomy for Hip Dysplasia?
Background: The purpose of this study was to (1) evaluate preoperative pelvic tilt utilizing the sacro-femoral-pubic (SFP) angle on standing pelvic x-rays, and (2) determine if the SFP angle changes after a unilateral or bilateral PAO.
Methods: A retrospective review was conducted of PAOs performed by a single hip preservation surgeon from November 2018 to November 2023. Standing x-rays were reviewed at 4 time points: preoperative, subacute postoperative, 6-month follow-up, and 12-month follow-up. Data collected included demographics, lateral center-edge angle (LCEA), Tönnis angle, and sacro-femoral-pubic (SFP) angle (a surrogate metric for pelvic tilt). Linear mixed models and Wilcoxon signed-rank tests were used to evaluate preoperative to postoperative differences in pelvic tilt for the unilateral and bilateral PAO groups, respectively.
Results: Seventy-four patients met inclusion criteria, consisting of 53 unilateral and 21 bilateral PAO patients (18.5±4.1 vs. 21.3±5.1 y, 90.6% vs. 95.2% female, LCEA 17.5 deg±6.5 deg vs. 18.0 deg±5.5 deg and 18.0 deg±6.3 deg, respectively). The Average preoperative pelvic tilt, calculated from the SFP angle, for the unilateral and bilateral PAO patients were 9.1 degrees±5.5 degrees and 8.1 degrees±5.6 degrees, respectively. These values increased postoperatively at average 7-week (-0.3 deg±3.4 deg and 1.3 deg±3.7 deg), 6-month (1.1 deg±3.8 deg and 2.7 deg±3.4 deg), and 12-month (1.0 deg±4.1 deg and 2.7 deg±3.0 deg) follow-up. Significant differences in pelvic tilt were observed from preoperative x-rays to 6 months ( P =0.002) and 12 months ( P =0.001) for the bilateral PAO patients, whereas the unilateral group demonstrated similar pelvic tilt at all time points ( P =0.09).
Conclusion: Patients undergoing bilateral PAO demonstrated an average increase in pelvic tilt of 2.7 degrees as measured by SFP angle at 6 months and 12 months postoperatively, suggesting a compensatory adaptation after surgery that may have implications in rehabilitation regimens and planned surgical corrections.
期刊介绍：
Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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