Beck Martin, Leunig Michael, Parvizi Javad, Boutier Vincent, Wyss Daniel, Ganz Reinhold
Department of Orthopaedic Surgery, University of Berne, Inselspital, Berne, Switzerland.
Clin Orthop Relat Res. 2004 Jan(418):67-73.
Femoroacetabular impingement has been shown to cause labral and chondral lesions and leads to osteoarthrosis of the hip. With the elimination of the pathogenic cause we hope to prevent or delay additional degeneration of the hip. Fourteen men and five women with a mean age of 36 years (range, 21-52 years) were treated with a surgical dislocation and offset creation of the hip. The followup averaged 4.7 years (range, 4-5.2 years). Using the Merle d'Aubigné hip score, 13 hips were rated excellent to good, with the pain score improving from 2.9 points to 5.1 points at the latest followup. There was no avascular necrosis of the femoral head. Five of the 19 patients, two with Grade 2 osteoarthrosis, two with Grade 1 osteoarthrosis but severe acetabular cartilage damage, and one with untreated ossified labrum had subsequent total hip arthroplasty (THA). In the stable hips without subluxation of the head into the acetabular cartilage defect, no additional joint space narrowing occurred. Surgical dislocation with correction of femoroacetabular impingement yields good results in patients with early degenerative changes not exceeding Grade 1 osteoarthrosis. This procedure is not suitable for patients with advanced degenerative changes and extensive articular cartilage damage.
股骨髋臼撞击症已被证实可导致盂唇和软骨损伤，并引发髋关节骨关节炎。通过消除致病因素，我们希望预防或延缓髋关节的进一步退变。对14名男性和5名女性患者进行了手术脱位并重建髋关节偏移，平均年龄为36岁（范围21 - 52岁）。随访平均4.7年（范围4 - 5.2年）。采用Merle d'Aubigné髋关节评分，13个髋关节评定为优至良，在最近一次随访时疼痛评分从2.9分提高到5.1分。未发生股骨头缺血性坏死。19例患者中有5例接受了全髋关节置换术（THA），其中2例为2级骨关节炎，2例为1级骨关节炎但髋臼软骨严重损伤，1例为未治疗的盂唇骨化。在股骨头未向髋臼软骨缺损处半脱位的稳定髋关节中，未出现额外的关节间隙变窄。对于早期退变改变不超过1级骨关节炎的患者，通过手术脱位矫正股骨髋臼撞击症可取得良好效果。该手术不适用于晚期退变改变和广泛关节软骨损伤的患者。
