与真正的髋关节发育不良相比，边缘性髋关节发育不良患者报告的预后较差

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-09-04 DOI:10.1002/jeo2.70407

Quentin Karisch, Marco Haertlé, Justus Stamp, Nikolai Ramadanov, Henning Windhagen, Sufian S. Ahmad

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引用次数: 0

摘要

目的：影响发育性髋关节发育不良（DDH）患者报告的预后指标（PROMs）的因素尚不清楚。本研究的目的是确定髋关节相关PROMs在交界性和真髋关节发育不良中的差异。方法选取245例有症状的DDH患者。髋部分为边缘性发育不良（外侧中心边缘角[LCEA] 20°-25°）和真性发育不良（LCEA < 20°）。从所有患者中提取prom。进行线性回归分析以确定与PROMs相关的潜在因素。评估PROMs与发育不良特征的关系以及DDH患者与健康人之间的关系。结果在加州大学和洛杉矶分校活动量表（UCLA）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、Merle d' aubign和postel评分以及德国遗忘关节评分（G-FJS）上，边缘性髋关节发育不良患者的得分明显低于真正的发育不良患者。与对照组相比，DDH患者的所有PROMs均显著降低。在真正发育不良的患者中，体重指数（BMI）成为影响髋关节残疾和骨关节炎结局评分-身体功能简表（HOOS-PS）、WOMAC、国际髋关节结局工具12 （iHOT-12）和Harris髋关节评分（HHS）的最重要因素。相比之下，在交界性发育不良患者中，前壁覆盖等影像学参数显著影响WOMAC、iHOT-12、HHS、改良HHS和G-FJS，而LCEA与UCLA和HOOS-PS评分相关。年龄被认为是交界性发育不良的重要预测因素。结论与真正的异常增生相比，边缘性异常增生患者报告的PROMs较差，这表明这组患者的临床和诊断负担明显。此外，与高BMI相关的机械负荷增加似乎仅在真正的不典型增生患者中发挥更大作用。证据等级三级。

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Patients with borderline hip dysplasia present with inferior patient-reported outcomes compared to true hip dysplasia

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Patients with borderline hip dysplasia present with inferior patient-reported outcomes compared to true hip dysplasia

Purpose

The factors influencing patient-reported outcome measures (PROMs) in individuals with developmental dysplasia of the hip (DDH) remain poorly understood. The aim of this study was to determine the differences in hip-related PROMs in both borderline and true hip dysplasia.

Methods

A total of 245 patients with symptomatic DDH were enrolled. Hips were divided into either borderline dysplasia (lateral centre-edge angle [LCEA] 20°–25°) or true dysplasia (LCEA < 20°). PROMs were retrieved from all patients. Linear regression analysis was performed to identify potential factors associated with PROMs. The relationship between PROMs and the characteristic of dysplasia and between patients with DDH and healthy people was assessed.

Results

Patients with borderline hip dysplasia had significantly poorer scores compared to true dysplasia on the University of California and Los Angeles activity scale (UCLA), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Merle d'Aubigné and postel score and the German forgotten joint score (G-FJS). In patients with DDH, all PROMs were significantly lower compared to the control group. In patients with true dysplasia, body mass index (BMI) emerged as the most influential factor affecting the hip disability and osteoarthritis outcome score–physical function shortform (HOOS-PS), WOMAC, International Hip Outcome Tool 12 (iHOT-12) and Harris hip score (HHS). In contrast, in patients with borderline dysplasia, radiographic parameters such as anterior wall coverage significantly influenced the WOMAC, iHOT-12, HHS, modified HHS and G-FJS, while the LCEA was associated with UCLA and HOOS-PS scores. Age was identified as a significant predictor in borderline dysplasia.

Conclusion

Patients with borderline dysplasia report poorer PROMs compared to true dysplasia, suggesting a distinct clinical and diagnostic burden in this group of patients. Moreover, the increased mechanical load associated with higher BMI appears to play a greater role only in patients with true dysplasia.