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杉冈截骨术治疗股骨头坏死的至少10年随访结果

Minimum 10-year results of Sugioka's osteotomy for femoral head osteonecrosis.

作者信息

Inao S, Ando M, Gotoh E, Matsuno T

机构信息

Department of Orthopaedic Surgery, Asahikawa Medical College, Japan.

出版信息

Clin Orthop Relat Res. 1999 Nov(368):141-8.

Abstract

Sugioka's transtrochanteric rotational osteotomy was performed on 14 hips (12 patients) before 1987 for avascular necrosis of the femoral head involving a large part of the weight-bearing area. Three hips required a secondary total hip arthroplasty within 5 years after the osteotomy. The remaining 11 hips were examined at a mean of 13.2 years after surgery (range, 10-17.7 years). The clinical and radiologic results were related to the preoperative radiographic stage of the disease. In the hips with less than 2 mm of collapse, highly satisfactory results were maintained more than 15 years after surgery, with minimal development of degenerative changes. In hips with 2 mm or more of collapse or with acetabular changes, the results tended to deteriorate gradually during the long course of observation but were fairly acceptable. This study shows the osteotomy can enable hip joints to survive and function well for more than 10 years with proper patient selection and operative procedure.

摘要

1987年以前,对14个髋关节(12例患者)实施了杉冈经转子旋转截骨术,用于治疗股骨头缺血性坏死,坏死累及大部分负重区。3个髋关节在截骨术后5年内需要二期全髋关节置换术。其余11个髋关节在术后平均13.2年(范围为10 - 17.7年)接受检查。临床和放射学结果与术前疾病的放射学分期相关。在塌陷小于2毫米的髋关节中,术后15年以上保持了高度满意的结果,退行性改变发展极少。在塌陷2毫米或以上或有髋臼改变的髋关节中,在长期观察过程中结果往往逐渐恶化,但仍相当可接受。本研究表明,通过适当的患者选择和手术操作,截骨术可使髋关节存活并良好功能超过10年。

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