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[全髋关节置换术治疗发育性髋关节发育不良]

[Total hip arthroplasty in the treatment of developmental dysplasia of the hip].

作者信息

Tözün I Remzi, Beksaç Burak, Sener Nadir

机构信息

Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Istanbul University, Istanbul, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2007;41 Suppl 1:80-6.

Abstract

Total hip arthroplasty (THA) is the preferred treatment for patients with severe arthritis of the hip secondary to developmental hip dislocation or dysplasia. However, THA may be difficult due to bone and soft tissue problems that arise from hip dislocation or dysplasia. Another problem is that patients are usually young, which may affect the long-term survival of the prosthesis. Either cemented or uncemented components can be used depending on bone structure and bone stock. Uncemented components are more preferable because of the young age of the patients. From a biomechanical standpoint, the placement of the acetabular component in its true anatomical location is the main goal for survival and better functional results of THA. To ascertain the stability of the acetabular component, superior grafting, controlled medial wall perforation (medialization), or giving the position of a high hip center may be used. On the femoral side, various femoral components may be used with or without a shortening osteotomy. In this article, reconstruction options for developmental hip dysplasia are discussed depending on acetabular and femoral features of the deformity.

摘要

全髋关节置换术(THA)是继发于发育性髋关节脱位或发育不良的严重髋关节炎患者的首选治疗方法。然而,由于髋关节脱位或发育不良引起的骨和软组织问题,THA可能具有挑战性。另一个问题是患者通常较为年轻,这可能会影响假体的长期生存率。根据骨结构和骨量,可以使用骨水泥型或非骨水泥型假体组件。由于患者年龄较轻,非骨水泥型组件更可取。从生物力学角度来看,将髋臼组件放置在其真正的解剖位置是THA获得长期生存和更好功能结果的主要目标。为确定髋臼组件的稳定性,可采用上方植骨、控制内侧壁穿孔(内移)或抬高髋关节中心位置等方法。在股骨侧,可使用各种股骨组件,可进行或不进行缩短截骨术。在本文中,将根据髋臼和股骨畸形的特征讨论发育性髋关节发育不良的重建方案。

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