Young adult patients with symptomatic acetabular dysplasia and marginal secondary osteoarthritis can be faced with the decision to either undergo periacetabular osteotomy (PAO) to relieve symptoms and slow osteoarthritis progression or wait until progression to more advanced disease and undergo total hip arthroplasty (THA). The decision can be difficult, and contemporary literature to guide these decisions is sparse. Therefore, we retrospectively assessed complication rate, survivorship and patient-reported clinical outcomes [modified Harris Hip score (mHHS), UCLA Activity score] in two, consecutive cohorts of patients aged 18–40 years that underwent either PAO for symptomatic acetabular dysplasia (mean age 28.9 years) or THA for advanced secondary osteoarthritis (32.5 years). PAO patients were followed for a mean of 10.5 years (8–19) and THA patients for 11.9 (8–17) years. Between PAO and THA groups, there were no differences in overall complication rate (4.7% versus 4.7%), non-revision reoperation rate (5.9% versus 2.3%, P = 0.37) or end-revision rate [7 (8.2%) PAOs converted to THA at mean 10.8 years versus 3 (7.0%) THAs revised at 6.2 years, P = 0.80]. Latest scores remained significantly improved from baseline in both the PAO (mHHS 86.1 versus 63.3, P < 0.001; UCLA 7.5 versus 6.9, P < 0.05) and THA (mHHS 82.6 versus 48.4, P < 0.001; UCLA 7.2 versus 4.6, P < 0.001) cohorts. Final scores were similar between groups (mHHS 86.1 versus 82.6, P = 0.46; UCLA 7.5 versus 7.2, P = 0.37). Clinical success [mHHS minimal clinically important difference (8) OR PASS (>70) at latest follow-up without end-revision] was achieved in 81.2% of PAO hips and 83.7% of THA hips (P = 0.72).

中文翻译：

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现代髋臼周围截骨术治疗髋关节发育不良与全髋关节置换术治疗髋骨关节炎的比较——年轻成人患者的 10 年结果具有可比性

患有症状性髋臼发育不良和边缘性继发性骨关节炎的年轻成年患者可能面临接受髋臼周围截骨术（PAO）以缓解症状和减缓骨关节炎进展或等到进展为更晚期疾病并接受全髋关节置换术（THA）的决定。这个决定可能很困难，指导这些决定的当代文献很少。因此，我们回顾性评估了两个连续的 18-40 岁患者队列中的并发症发生率、存活率和患者报告的临床结果 [修正的 Harris 髋关节评分 (mHHS)、UCLA 活动评分]，这些患者因症状性髋臼发育不良接受了任一 PAO（平均年龄 28.9 岁）或 THA 治疗晚期继发性骨关节炎（32.5 岁）。PAO 患者平均随访 10 次。5 年 (8-19) 和 THA 患者 11.9 (8-17) 年。在 PAO 和 THA 组之间，总体并发症发生率（4.7% 对 4.7%）、非翻修再手术率（5.9% 对 2.3%，P = 0.37）或最终翻修率 [7 (8.2%) PAO平均 10.8 年转换为 THA，而 6.2 年修订为 3 个 (7.0%) THA，P = 0.80]。在 PAO（mHHS 86.1 对 63.3，P < 0.001；UCLA 7.5 对 6.9，P < 0.05）和 THA（mHHS 82.6 对 48.4，P < 0.001；UCLA 7.2 对 4.6， P < 0.001) 组。各组之间的最终得分相似（mHHS 86.1 对 82.6，P = 0.46；UCLA 7.5 对 7.2，P = 0.37）。临床成功 [mHHS 最小临床重要差异 (8) 或通过 (>70) 在最近的随访中没有结束修订] 在 81 中实现。