Troelsen A, Elmengaard B, Søballe K
Orthopaedic Research Unit, University Hospital of Aarhus, Buildings 7B (A.T. and B.E.) and 1B, Tage-Hansens Gade 2, DK-8000 Aarhus, Denmark.
J Bone Joint Surg Am. 2008 Mar;90(3):493-8. doi: 10.2106/JBJS.F.01399.
A new minimally invasive transsartorial approach for the Bernese periacetabular osteotomy was developed. We investigated whether this technique was safe and successful with regard to minimizing tissue trauma and, more importantly, whether it was possible to obtain optimal reorientation of the acetabulum.
Our experience with this approach was retrospectively assessed by means of database inquiry and the evaluation of radiographs. We assessed ninety-four procedures performed between April 2003 and August 2005 to determine perioperative and early postoperative outcome measures, the achieved acetabular reorientation, and hip joint survival.
The mean duration of surgery was 73.1 minutes, the median perioperative blood loss was 250 mL, and the mean reduction in the hemoglobin level was 33 g/L. Blood transfusion was required following 3% of the procedures. No injuries to the great vessels or nerves, arterial thromboses, unintended extension of the osteotomy, or deep infections occurred. The postoperative acetabular reorientation was assessed by measuring the center-edge and acetabular index angles, the medians of which were 34 degrees and 3 degrees , respectively. With total hip arthroplasty as the end point, the hip joint survival rate was estimated to be 98% at 4.3 years.
Osteotomy with use of this minimally invasive transsartorial approach appears to be a safe, relatively short surgical procedure associated with a relatively small amount of blood loss and minimal transfusion requirements. Optimal acetabular reorientation can be achieved with this technique.
一种用于伯尔尼髋臼周围截骨术的新型微创经动脉方法被研发出来。我们研究了该技术在使组织创伤最小化方面是否安全且成功，更重要的是，能否实现髋臼的最佳重新定向。
通过数据库查询和X线片评估，对我们应用该方法的经验进行回顾性分析。我们评估了2003年4月至2005年8月期间实施的94例手术，以确定围手术期和术后早期的结果指标、实现的髋臼重新定向以及髋关节生存率。
手术平均时长为73.1分钟，围手术期失血中位数为250毫升，血红蛋白水平平均下降33克/升。3%的手术需要输血。未发生大血管或神经损伤、动脉血栓形成、截骨意外延长或深部感染。通过测量中心边缘角和髋臼指数角评估术后髋臼重新定向，其角度中位数分别为34度和3度。以全髋关节置换作为终点，4.3年时髋关节生存率估计为98%。
采用这种微创经动脉方法进行截骨术似乎是一种安全、相对简短的手术，出血量相对较少且输血需求最小。使用该技术可实现髋臼的最佳重新定向。
