Lou Lie-ming, Yao Zhen-jun, Wu Wei-ping, Ran Yong-xin, Wu Xing, Li Shao-hua
Department of Orthopaedics, Shanghai Tenth Hospital, Shanghai Tongji University, Shanghai 200072, China.
Zhonghua Wai Ke Za Zhi. 2007 Aug 15;45(16):1095-7.
To summarize the surgical experience of release and balance of soft tissues around hip in total hip arthroplasty for patients with severe hip dysplasia.
From January 2001 to January 2006, 29 patients (31 hips) of adult dysplasia of hip were included in the study. Among them, there were 22 females and 7 males, age from 38 to 65 years with average of 53 years. According to Crowe classification system, there were 22 in type III, 9 in type IV, and Harris score was 42.6 preoperatively. Total hip arthroplasty was performed via lateral approach. All the acetabular cups were reconstructed at the original anatomic location through release of soft tissue around hip to restore limb length, and techniques of balance of soft tissue were applied to extend force arm of hip abductor and improve its function.
All the patients had restoration of limb length (ranged from 2.5 cm to 4.5 cm). One case of postoperative dislocation was occurred due to slight large of acetabular obtuse angle. Follow-up for 1-5 years (average 3.2 years) in 29 patients, the Harris score increased to 85.4 postoperatively. All hips had released from pain and functioned well.
In order to restoration anatomic structure and physiologic function of affected hip, the technique of release and balance of soft tissues around hip should be applied and cautioned in arthroplasty of dysplastic hip.
总结重度髋关节发育不良患者全髋关节置换术中髋关节周围软组织松解与平衡的手术经验。
2001年1月至2006年1月，纳入29例（31髋）成人髋关节发育不良患者进行研究。其中女性22例，男性7例，年龄38至65岁，平均53岁。根据Crowe分类系统，III型22例，IV型9例，术前Harris评分为42.6分。采用外侧入路行全髋关节置换术。通过松解髋关节周围软组织，将所有髋臼杯重建于原解剖位置以恢复肢体长度，并应用软组织平衡技术延长髋关节外展肌的力臂，改善其功能。
所有患者肢体长度均得以恢复（范围为2.5厘米至4.5厘米）。因髋臼钝角稍大发生1例术后脱位。29例患者随访1至5年（平均3.2年），术后Harris评分提高至85.4分。所有髋关节疼痛缓解，功能良好。
在发育不良髋关节置换术中，应用髋关节周围软组织松解与平衡技术时应谨慎，以恢复患髋的解剖结构和生理功能。
