Analysis Of Influencing Factors Of Preoperative Pain And Postoperative Function In Bernese Periacetabular Osteotomy

[Objective]To explore the influencing factors of preoperative pain and influencing factors of postoperative function of Bernese periacetabular osteotomy.[Methods]A retrospective study of 44 patients with developmental hip dysplasia who underwent Bernese periacetabular osteotomy with modified Smith-Peterson approach from January 2017 to November 2019 was carried out,and the preoperative and postoperative imaging indicators was measured.The follow-up time was 1 to 3.9 years after operation,with an average of 2.1 years.Observed the acetabular top tilt angle,lateral central edge angle(LCEA),acetabular abduction angle(ABA),femoral head extrusion index(EI),sphericity index of femoral head,Shenton line,Tonnis grade of osteoarthritis,joint congruency,p/a ratio,acetabular anteversion angle(AAA),Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)pain score and modified Harris score(MHHS).According to the WOMAC pain score,the preoperative pain was divided into five grades:mild pain(1-4 points),moderate pain(5-8 points),more severe pain(9-12 points),severe pain(13-16 points),and extremely severe pain(17-20 points).MHHS were divided into three clinically relevant categories:poor(<70 points),good(70-85 points),and excellent(86-91 points).Using regression analysis to determine the preoperative pain degree and postoperative function influencing factors.[Results]According to logistic regression analysis,for each increase of age by one unit,the probability of preoperative pain level increasing by one level is 1.1 times(OR:1.090,95%CI:1.018-1.157,p=0.012).For every increase in body mass index(BMI)by one unit,it is 1.2 times more likely that the preoperative pain level will increase by one level(OR:1.244,95%CI:1.050-1.474,p=0.011).For every unit increase in the LCEA,the postoperative MHHS is 1.2 times more likely to be classified as excellent(OR:1.183,95%CI:1.077-1.299,p<0.01).Regression analysis of other factors found no significant correlation with preoperative pain and postoperative functional score.The patient’s MHHS increased from 70 points before surgery to 91 points after surgery(p<0.01),WOMAC pain score decreased from 4 points before surgery to 0 points after surgery(p<0.01).[Conclusion]The overall function score of patients after Bernese periacetabular osteotomy was significantly improved,and the pain symptoms were significantly reduced.Patients with higher age and BMI have more severe preoperative pain.Patients with larger LCEA will have better joint function after surgery.