Aims This study aimed to determine clinical outcomes; relationships between postoperative anterior, lateral, and posterior acetabular coverage and joint survival; and prognostic factors for joint survival after transposition osteotomy of the acetabulum (TOA). Methods Data from 616 patients (800 hips) with hip dysplasia who underwent TOA between November 1998 and December 2019 were reviewed. The median follow-up period was 8.9 years (IQR 5 to 14). A medical notes review was conducted to collect demographic data, complications, and modified Harris Hip Score (mHHS). Radiological indicators of acetabular coverage included lateral centre-edge angle (LCEA), anterior wall index (AWI), and posterior wall index (PWI). The cumulative probability of TOA failure (progression to Tönnis grade 3 or conversion to total hip arthroplasty) was estimated using the Kaplan-Meier product-limited method. A multivariate Cox proportional hazards model was used to identify predictors for failure. Results Median mHHS improved from 68 preoperatively to 96 at the latest follow-up (p < 0.001). The overall joint survival rate was 97% at ten years and 70% at 20 years. For the postoperative LCEA subgroups, survival in the deficient group was lower than that in the excessive (p = 0.006) and normal (p = 0.007) groups. For the postoperative AWI subgroups, survival in the deficient group was lower than that in the excessive (p = 0.015) and normal (p < 0.001) groups. Multivariate analysis identified age (p = 0.010), Tönnis grade 2 (p < 0.001), roundness index (p = 0.003), fair joint congruity (p = 0.004), and postoperative AWI (p = 0.002) as independent risk factors. Conclusion Deficient postoperative AWI adversely affected joint survival after TOA, underscoring the importance of sufficient anterior acetabular coverage, along with precise surgical indications, to ensure successful hip joint preservation in the treatment of hip dysplasia.

中文翻译：

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术后前壁指数缺陷对髋关节发育不良患者髋臼转位截骨术后的关节存活产生不利影响。


目的 本研究旨在确定临床结局;术后髋臼前、外侧和后髋臼覆盖与关节存活率之间的关系;以及髋臼转位截骨术后关节生存的预后因素 （TOA）。方法 回顾了 1998 年 11 月至 2019年12月接受 TOA 的 616 例髋关节发育不良患者 （800 只髋关节） 的数据。中位随访期为 8.9 年 （IQR 5 至 14）。进行了医疗记录审查以收集人口统计数据、并发症和改良的 Harris 髋关节评分 （mHHS）。髋臼覆盖的放射学指标包括外侧中心边缘角 （LCEA） 、前壁指数 （AWI） 和后壁指数 （PWI）。使用 Kaplan-Meier 产品限制法估计 TOA 失败的累积概率 （进展为 Tönnis 3 级或转换为全髋关节置换术）。使用多变量 Cox 比例风险模型来确定失败的预测因子。结果 中位 mHHS 从术前 68 改善到最近一次随访时的 96 （p < 0.001）。总体关节生存率在 10 年时为 97%，在 20 年时为 70%。对于术后 LCEA 亚组，缺陷组的生存率低于过度 （p = 0.006） 和正常 （p = 0.007） 组。对于术后 AWI 亚组，缺陷组的生存率低于过度 （p = 0.015） 和正常 （p < 0.001） 组。多变量分析确定年龄 （p = 0.010）、Tönnis 2 级 （p < 0.001）、圆度指数 （p = 0.003）、公平关节一致性 （p = 0.004） 和术后 AWI （p = 0.002） 是独立的危险因素。 结论 术后 AWI 缺陷对 TOA 后的关节生存产生不利影响，强调了足够的髋臼前覆盖以及精确的手术指征的重要性，以确保在治疗髋关节发育不良中成功保留髋关节。