Thacker Mihir M, Feldman David S, Madan Sanjeev S, Straight Joseph J, Scher David M
Pediatric Orthopaedic Surgery, Center for Children, NYU Hospital for Joint Diseases, New York, New York, USA.
J Pediatr Orthop. 2005 Mar-Apr;25(2):178-82. doi: 10.1097/01.bpo.0000150811.33920.27.
From 1996 to 2000, 11 adolescents with hip joint arthritis secondary to osteonecrosis or idiopathic chondrolysis were treated with articulated hinged distraction arthroplasty. Indications for surgery were severe pain and limited ambulation. Charts and radiographs were reviewed. Clinical status was assessed preoperatively and at latest follow-up (mean 4.8 years after surgery) using criteria of pain, range of motion, and ambulation level. Ten patients showed improved clinical status, with seven having an excellent outcome and three a good outcome. One patient failed distraction. Mean joint space was 2.6 mm before surgery and 4.8 mm at latest follow-up. Average duration of fixator use was 4.4 months. Four patients (36.4%) had complications. Articulated hip distraction was effective in eliminating pain, improving function, and preventing progressive degenerative changes in young patients' hips. It should be considered a salvage procedure for arthritic hips and an alternative to arthrodesis in this difficult-to-treat group of patients.
1996年至2000年期间，11例继发于骨坏死或特发性软骨溶解的青少年髋关节关节炎患者接受了带关节铰链式撑开关节成形术治疗。手术指征为严重疼痛和行走受限。回顾了病历和X光片。术前及最新随访（平均术后4.8年）时，依据疼痛、活动范围和行走水平标准对临床状况进行评估。10例患者临床状况改善，其中7例效果极佳，3例效果良好。1例患者撑开失败。术前平均关节间隙为2.6毫米，最新随访时为4.8毫米。固定器平均使用时间为4.4个月。4例患者（36.4%）出现并发症。带关节铰链式髋关节撑开术对于消除年轻患者髋关节疼痛、改善功能及预防渐进性退行性改变有效。对于关节炎性髋关节，应将其视为一种挽救性手术，对于这类难以治疗的患者群体，可作为关节融合术的替代方法。
