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Does the use of i-FACTOR bone graft affect bone healing in those undergoing periacetabular osteotomy (PAO) for developmental dysplasia of the hip (DDH)? A retrospective study
Journal of Hip Preservation Surgery ( IF 1.4 ) Pub Date : 2022-06-28 , DOI: 10.1093/jhps/hnac027
Michael J M O'Brien 1, 2 , Denise M Jones 1 , Adam Ivan Semciw 3 , Jitendra Balakumar 4 , Rafal Grabinski 5 , Justin Roebert 5 , Georgia M Coburn 1 , Inger Mechlenburg 6, 7 , Joanne L Kemp 1
Affiliation  

The aims of this study were to compare, in patients with and without the use of i-FACTOR bone graft during periacetabular osteotomy (PAO) surgery for developmental dysplasia of the hip (DDH), (i) bone healing at six-weeks post-operatively (ii) rate of complications. This was a retrospective review of case records. Participants were people aged 15-50 years undergoing rectus-sparing minimally invasive PAO surgery for DDH. Group 1: patients with i-FACTOR, Group 2: No i-FACTOR. The primary outcome was the rate of bone healing on radiographs at 6 weeks. The likelihood of bone healing was compared using logistic regression with Generalised Estimating Equations (GEE) and expressed as odds ratios (95% confidence intervals (CIs; P < 0.05)). The occurrence of complications was extracted from surgical records. The i-FACTOR group had 3-times greater odds of partial/full union than those without [adjusted odds ratio (95% CIs, P-value)]: [3.265 (1.032 to 10.330, P = 0.044)]. The i-FACTOR group had 89% partial/full union at 6-weeks, compared to 69% of the non-i-FACTOR group. Half of the patients had leaking of bone graft in the i-FACTOR group versus 10% in the non-i-FACTOR group, 26% of the i-FACTOR group and 12% of the non-i-FACTOR group had neuropraxia of the lateral femoral cutaneous nerve (LFCN). Complication rates were low, and similar between groups. However, the rate of LFCN neuropraxia and bone graft leakage was higher in the i-FACTOR. These findings should be confirmed in a future prospective randomised clinical trial and include outcomes such as pain and quality of life.

中文翻译:

使用 i-FACTOR 植骨是否会影响因发育性髋关节发育不良 (DDH) 而接受髋臼周围截骨术 (PAO) 的患者的骨愈合?一项回顾性研究

本研究的目的是比较在髋臼周围截骨术 (PAO) 手术治疗发育性髋关节发育不良 (DDH) 期间使用和不使用 i-FACTOR 骨移植的患者,(i) 术后 6 周的骨愈合情况手术 (ii) 并发症发生率。这是对病例记录的回顾性审查。参与者年龄在 15-50 岁之间,正在接受保留直肌的微创 PAO 手术治疗 DDH。第 1 组:具有 i-FACTOR 的患者,第 2 组:没有 i-FACTOR。主要结果是 6 周时 X 光片上的骨愈合率。使用逻辑回归与广义估计方程 (GEE) 比较骨愈合的可能性,并表示为比值比(95% 置信区间 (CIs;P < 0.05))。并发症的发生是从手术记录中提取的。i-FACTOR 组部分/完全结合的几率比没有 [调整后的优势比(95% CI,P 值)] 的那些高 3 倍:[3.265(1.032 至 10.330,P = 0.044)]。i-FACTOR 组在 6 周时有 89% 的部分/完全结合,而非 i-FACTOR 组为 69%。i-FACTOR 组中一半的患者出现骨移植物渗漏,而非 i-FACTOR 组中为 10%,i-FACTOR 组中 26% 的患者和非 i-FACTOR 组中 12% 的患者出现神经失用症股外侧皮神经(LFCN)。并发症发生率很低,并且组间相似。然而,在 i-FACTOR 中,LFCN 神经失用和骨移植渗漏的发生率更高。这些发现应在未来的前瞻性随机临床试验中得到证实,包括疼痛和生活质量等结果。P 值)]:[3.265(1.032 至 10.330,P = 0.044)]。i-FACTOR 组在 6 周时有 89% 的部分/完全结合,而非 i-FACTOR 组为 69%。i-FACTOR 组中一半的患者出现骨移植物渗漏,而非 i-FACTOR 组中为 10%,i-FACTOR 组中 26% 的患者和非 i-FACTOR 组中 12% 的患者出现神经失用症股外侧皮神经(LFCN)。并发症发生率很低,并且组间相似。然而,在 i-FACTOR 中,LFCN 神经失用和骨移植渗漏的发生率更高。这些发现应在未来的前瞻性随机临床试验中得到证实,包括疼痛和生活质量等结果。P 值)]:[3.265(1.032 至 10.330,P = 0.044)]。i-FACTOR 组在 6 周时有 89% 的部分/完全结合,而非 i-FACTOR 组为 69%。i-FACTOR 组中一半的患者出现骨移植物渗漏,而非 i-FACTOR 组中为 10%,i-FACTOR 组中 26% 的患者和非 i-FACTOR 组中 12% 的患者出现神经失用症股外侧皮神经(LFCN)。并发症发生率很低,并且组间相似。然而,在 i-FACTOR 中,LFCN 神经失用和骨移植渗漏的发生率更高。这些发现应在未来的前瞻性随机临床试验中得到证实,包括疼痛和生活质量等结果。i-FACTOR 组中一半的患者出现骨移植物渗漏,而非 i-FACTOR 组中为 10%,i-FACTOR 组中 26% 的患者和非 i-FACTOR 组中 12% 的患者出现神经失用症股外侧皮神经(LFCN)。并发症发生率很低,并且组间相似。然而,在 i-FACTOR 中,LFCN 神经失用和骨移植渗漏的发生率更高。这些发现应在未来的前瞻性随机临床试验中得到证实,包括疼痛和生活质量等结果。i-FACTOR 组中一半的患者出现骨移植物渗漏,而非 i-FACTOR 组中为 10%,i-FACTOR 组中 26% 的患者和非 i-FACTOR 组中 12% 的患者出现神经失用症股外侧皮神经(LFCN)。并发症发生率很低,并且组间相似。然而,在 i-FACTOR 中,LFCN 神经失用和骨移植渗漏的发生率更高。这些发现应在未来的前瞻性随机临床试验中得到证实,包括疼痛和生活质量等结果。
更新日期:2022-06-28
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