It is unclear whether treatment of intraarticular pathology should be performed during periacetabular osteotomy (PAO) to improve outcomes. Therefore, we asked: (i) What are the clinical results of PAO in patients with and without intraarticular intervention? (ii) Is there a difference in reoperations with and without intraarticular intervention? and (iii) Is there a difference in clinical results and reoperations depending on preoperative Tönnis Grade if intraarticular intervention is performed? Prospective evaluation of 161 PAO in 146 patients was performed. The cohort was 84.5% female, mean age was 26.7 ± 7.9 years and mean follow-up was 2.4 years; 112 hips had Grade 0 changes and 49 hips had Grade 1 changes. Patients were classified into three groups based on treatments during PAO: major (labral repair, femoral head–neck osteochondroplasty), minor (labral debridement, femoral/acetabular chondroplasty) or no intervention. A subset of eight patient-reported outcome measures (PROMs) was analyzed to determine whether the minimal clinically important difference (MCID) was achieved. Major, minor and no intervention groups exceeded the MCID in 5, 8 and 8, of 8 PROMs (P ≥ 0.20), respectively; intraarticular interventions did not influence reoperation-free survival (P ≥ 0.35). By Tönnis Grade, PROMs exceeding MCID decreased in Grade 1 versus 0 receiving no intervention (P < 0.001) but did not decrease for either intervention (P ≥ 0.14); intraarticular interventions did not influence reoperation-free survival (P ≥ 0.38). Overall, intraarticular intervention was associated with excellent PROMs and reoperation-free survival. Although Grade 1 patients had fewer PROM which achieved MCID, intraarticular interventions attenuated this decrease, suggesting a therapeutic advantage of intraarticular procedures for more advanced pathology.

中文翻译：

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在髋臼周围截骨术中治疗关节内病变时，Tönnis 1 级发育不良髋关节改善了患者报告的结果评分

目前尚不清楚是否应在髋臼周围截骨术（PAO）期间进行关节内病变治疗以改善预后。因此，我们问：（i）PAO 在有和没有关节内干预的患者中的临床结果是什么？(ii) 有无关节内干预的再手术有区别吗？(iii) 如果进行关节内干预，临床结果和再手术是否会因术前 Tönnis 等级而有所不同？对 146 名患者的 161 份 PAO 进行了前瞻性评估。该队列为 84.5% 的女性，平均年龄为 26.7 ± 7.9 岁，平均随访时间为 2.4 年；112 髋发生 0 级改变，49 髋发生 1 级改变。根据 PAO 期间的治疗，将患者分为三组：主要（盂唇修复、股骨头-颈骨软骨成形术）、轻微（盂唇清创，股骨/髋臼软骨成形术）或不干预。分析了八个患者报告的结果测量 (PROM) 的子集，以确定是否达到了最小临床重要差异 (MCID)。主要、次要和无干预组在 8 个 PROM 中分别有 5、8 和 8 个超过 MCID（P ≥ 0.20）；关节内干预不影响无再手术生存率（P ≥ 0.35）。根据 Tönnis 等级，超过 MCID 的 PROM 在 1 级与未接受干预的 0 级相比有所下降（P < 0.001），但任一干预均未减少（P ≥ 0.14）；关节内干预不影响无再手术生存期（P ≥ 0.38）。总体而言，关节内干预与出色的 PROM 和无再手术生存率相关。尽管 1 级患者达到 MCID 的 PROM 较少，