摘要
目的探讨中青年髋臼发育不良继发骨关节炎采用髋臼旋转截骨术的临床疗效。方法回顾性分析11例髋臼发育不良继发骨关节炎患者,采用髋臼周围旋转截骨术同时行骨移植金属或可吸收螺钉固定。通过手术改变髋臼角及关节负重点,同时增加了股骨头的包容。本组患者手术时平均年龄为28.6岁,平均随访时间为3.5年。采用Harris髋关节评分对患者满意度、日常活动、关节功能、疼痛、步态、行走是否借助辅助器等进行了综合性评估。患者均接受了影像学检查。结果Harris评分从术前的70.6分上升到术后的89.7分。主要表现为疼痛减轻、步态改善、髋关节功能改善,尤其是旋转功能。负重时明显感觉稳定性增加。影像学检查髋臼角明显减小,从术前平均31°减少到术后22°左右。结论该手术对于髋臼发育不良继发骨关节炎患者效果明显,对于不适合全髋置换手术者应是首选且有效的方法,同时可减缓继发性骨关节炎的进展。
Objectives To explore the therapeutic effect of rotational acetabulum osteotomy(RAO) in the treatment of acetabulum dysplasia secondary to arthritis.Methods We retrospectively analyzed the outcomes of RAO performed in 11 patients with acetabulum dysplasia secondary to arthritis.Bone graft transplantation or fixation by metallic or reabsorptable screws was also perfomd.The weight point of joint and covering of femoral head was also changed.The average age was 28.6 years,and the mean following-up period was 3.5 years.Patients were evaluated by Harris hip scoring system and by imaging.Results The mean Harris score increased from 70.6 before operation to 89.7 after operation.The gait and hip joint pain improved.The joint function,especially in the rotation position,and the stability was also improved. Acetabular angle decreased from 31°before operation to 22°after operation.Conclusions RAO is effective in treating acetabulum dysplasia secondary to arthritis.For patients who are contraindicated to total hip arthroplasty,RAO is the operation of choice and can relieve the deterioration of secondary osteoarthritis.
出处
《中国骨与关节外科》
2008年第2期114-117,共4页
Chinese Journal of Bone and Joint Surgery
关键词
髋臼
发育不良
继发关节炎
截骨
acetabulum
dysplasia
secondary arthritis
osteotomy
