Do Active Pao Patients Maintain Their Activity Levels Over Mid-term Follow-up?
Notice bibliographique
Résumé
Objectives: Periacetabular osteotomy (PAO) is an established hip preservation technique for skeletally mature patients with symptomatic acetabular dysplasia. For athletes and physically active individuals undergoing PAO, returning to and maintaining a high level of activity postoperatively is a priority. The purpose of this study was to evaluate maintenance of activity levels at mid to long-term follow-up in active patients treated with the PAO. Methods: We conducted a retrospective review of patients who underwent PAO for symptomatic hip dysplasia at our institution from June 2006-August 2013. Patients were identified by review of the prospective Institutional Hip Database, which contains all patients who are treated with PAO. All patients who underwent PAO for acetabular deformity correction and had a UCLA score of 7 or higher preoperatively at time of surgery and at least 5 years of follow up were included in the study. Exclusion criteria consisted of patients with a preoperative UCLA score less than 7, history of trauma, neuromuscular or connective tissue disorder, diagnosis other than developmental hip dysplasia, previous surgery, or severe deformities such as seen after Perthes or SCFE. Patient-reported outcome measures included the UCLA activity score, modified Harris Hip Score (mHHS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the minimal clinically important difference (MCID) was identified. Maintenance of high level of activity was defined, as previously reported, as a UCLA score of 7 or higher at final follow-up. Radiographic parameters included the lateral center-edge angle (CEA), anterior CEA, acetabular index, and Tönnis classification. Statistical significance was defined as a p-value < 0.05. Results: A total of 360 PAOs were identified. Of these, 70 patients (79 hips) met the inclusion criteria, and follow-up was obtained in 59 patients (66 hips) (83.5%) and included in the final analysis. The mean age was 25 years (range 14-47 years), and mean follow-up was 6.8 years (range 5-11 years). All hips underwent a PAO, with concomitant surgeries being performed in 63/79 hips (80%). Femoral head/neck osteochondroplasty was performed in 62/66 hips (94%). Postoperative UCLA scores demonstrated maintenance of high activity level with UCLA score of at least 7 in 46/66 hips (70%). Harris hip score and WOMAC (total and all subsets) improved significantly (p<0.05) (Table 1). 77 percent of hips achieved MCID with mHHS, and 65% of hips achieved MCID with the WOMAC pain score. Lateral CEA, anterior CEA, acetabular inclination, true lateral alpha angle, Dunn alpha angle, and frog lateral alpha angle were significantly improved at final follow up (p<0.01). Tönnis classification showed progression from Grade 0 to Grade 1 in 3 hips. One hip was Tönnis grade 2 preoperatively and did not progress postoperatively. There were 0 conversions to total hip arthroplasty. There were 9 patients with clinical failure, signified by mHHS<70 at the latest follow-up. Conclusion: To our knowledge, this study is the first to evaluate level of activity in active patients at mid to long-term follow-up after PAO surgery. These data indicate excellent overall clinical outcomes (Mean UCLA-8, mHHS-88) with maintenance of high activity levels in 70% of patients. This information can provide surgeons and active patients with valuable information regarding mid to long-term activity profiles after PAO surgery. [Table: see text]
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».