[Crowe III型发育性髋关节髋臼重建]

[Reconstruction of the acetabular in the Crowe III dysplastic hip].

作者信息

Tang Jing, Shao Hong-yi, Tang Qi-heng, Liu Qing, Xu Hai-jun, Zhou Yi-xin

机构信息

Department of Adult Reconstructive Surgery, Beijing Jishuitan Hospital, Beijing 100035, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Sep 1;46(17):1303-6.

PMID:19094559

Abstract

OBJECTIVE

To investigate the method and the outcome of the acetabular reconstruction in the Crowe III dysplastic hip.

METHODS

From January 2001 to June 2007, 43 cases (54 hips) were diagnosed osteoarthritis secondary to Crowe III dysplastic hip. Total hip arthroplasty was performed in all cases. The Harris score was 39 pre-operation. The method of the acetabular reconstruction included acetabular deepening (group A), medial-wall osteotomy (group B), femoral head bone grafting (group C). Radiography data and Harris score were taken to evaluate the clinical outcome.

RESULTS

The method of the acetabular reconstruction included acetabular deepening in 27 cases (34 hips), medial-wall osteotomy in 12 cases (15 hips), femoral head bone grafting in 4 cases (5 hips). Forty cases were followed up by the mean time of 29 months. The bone union time of the osteotomy and bone grafting were 4 - 5 months postoperation. In the three groups the obliquity angle of the cup were (41.0 +/- 7.5) degrees , (46.0 +/- 7.7) degrees , (39.0 +/- 11.0) degrees ; the anteversion angle of the cup were (10.0 +/- 2.8) degrees , (9.0 +/- 2.5) degrees , (4.0 +/- 1.9) degrees ; the rotation center of the hip was shift superiorly (8.4 +/- 3.6) mm, (7.3 +/- 2.6) mm, (1.2 +/- 0.5) mm; the rotation center of the hip were shift internally (7.0 +/- 1.5) mm, (9.9 +/- 1.7) mm, (-2.7 +/- 1.2) mm, and the Harris score were 89, 91, 86 at the follow up. The complication included deep venous thrombosis in 2 cases, pulmonary embolism in 2 cases, sciatic nerve palsy in 4 cases.

CONCLUSION

Acetabular deepening, medial-wall osteotomy, femoral head bone grafting can be used in reconstruction of the acetabular in the Crowe III dysplastic hip.

摘要

目的

探讨Crowe III型发育性髋关节发育不良髋臼重建的方法及疗效。

方法

2001年1月至2007年6月，43例（54髋）诊断为Crowe III型发育性髋关节发育不良继发骨关节炎。所有病例均行全髋关节置换术。术前Harris评分为39分。髋臼重建方法包括髋臼加深（A组）、内壁截骨（B组）、股骨头植骨（C组）。采用影像学资料及Harris评分评估临床疗效。

结果

髋臼重建方法中，髋臼加深27例（34髋），内壁截骨12例（15髋），股骨头植骨4例（5髋）。40例获得随访，平均随访时间29个月。截骨及植骨的骨愈合时间为术后4 - 5个月。三组髋臼杯的倾斜角分别为（41.0±7.5）度、（46.0±7.7）度、（39.0±11.0）度；髋臼杯的前倾角分别为（10.0±2.8）度、（9.0±2.5）度、（4.0±1.9）度；髋关节旋转中心上移分别为（8.4±3.6）mm、（7.3±2.6）mm、（1.2±0.5）mm；髋关节旋转中心内移分别为（7.0±1.5）mm、（9.9±1.7）mm、（-2.7±1.2）mm，随访时Harris评分分别为89分、91分、86分。并发症包括深静脉血栓形成2例，肺栓塞2例，坐骨神经麻痹4例。