ABSTRACT Complex deformities of the hip requiring intra-articular and proximal femoral correction are challenging with regard to surgical access and complication risk. Combined surgical dislocation and proximal femoral osteotomy (SD/PFO) is a surgical strategy that provides unrestricted access to the joint with the capability for adjunctive PFO. Although providing excellent surgical access, concerns over a potentially high risk of postoperative complications remain, and published information on the safety of this technique remain scarce. In this study, we defined the early complication profile of combined surgery across 48 hips with a variety of complex deformities using a standardized, validated complication grading scheme for hip preservation surgery. Patients were mean age 19.1 years 13–33 years and 60% had previous surgery. At the early mean follow-up of 2.9 years, considerable improvement was seen across all outcome scores. Major complications (Grade III or higher) occurred at a rate of 4.2% (n = 2). Both were osteotomy non-unions, and both were treated successfully with revision PFO and bone grafting at mean 1.1 years. To our knowledge, the current series of combined SD-PFO surgeries represents the largest to date for which detailed complication data have been reported. Given the complexity of these disorders, a major complication rate of 4.2% is acceptable. Our complication rates were comparable to those reported for isolated SD and PFO procedures. These rates did not vary significantly across morphologic variants or patient-specific characteristics. Additionally, our complication risk profile is consistent with previous, smaller reports, which supports the generalizability of these results among appropriately experienced surgeons.

中文翻译：

---

联合手术脱位和股骨近端截骨术是矫正复杂髋关节畸形的安全手术吗？

摘要 需要关节内和股骨近端矫正的髋关节复杂畸形在手术入路和并发症风险方面具有挑战性。联合手术脱位和股骨近端截骨术 (SD/PFO) 是一种手术策略，可以不受限制地进入关节并具有辅助 PFO 的能力。尽管提供了出色的手术通路，但仍然存在对术后并发症潜在高风险的担忧，并且关于该技术安全性的已发表信息仍然很少。在这项研究中，我们使用标准化的、经过验证的髋关节保留手术并发症分级方案定义了 48 例髋关节手术的早期并发症特征，这些髋关节有各种复杂的畸形。患者的平均年龄为 19.1 岁至 13-33 岁，60% 曾接受过手术。在 2.9 年的早期平均随访中，所有结果评分都得到了显着改善。主要并发症（III 级或更高）的发生率为 4.2%（n = 2）。两者均为截骨不愈合，均在平均 1.1 年时通过 PFO 翻修和植骨成功治疗。据我们所知，目前的 SD-PFO 联合手术系列代表了迄今为止已报告详细并发症数据的最大手术。鉴于这些疾病的复杂性，4.2% 的主要并发症发生率是可以接受的。我们的并发症发生率与单独的 SD 和 PFO 程序报告的并发症发生率相当。这些比率在形态学变异或患者特定特征之间没有显着差异。此外，我们的并发症风险概况与之前的较小报告一致，