Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.
Clin Orthop Surg. 2009 Mar;1(1):19-26. doi: 10.4055/cios.2009.1.1.19. Epub 2009 Feb 6.
We performed a retrospective study to evaluate the results of acetabular circumferential medial wall osteotomy, a procedure designed to provide secure fixation of a cementless hemispherical acetabular cup for the sequelae of septic arthritis of the hip.
We assessed 38 total hip arthroplasties (THAs) with circumferential acetabular medial wall osteotomies performed on patients with sequelae of septic arthritis of the hip between 1993 and 2000, who were followed up for > or = 3 years. The average follow-up period was 8.3 years (range, 3 to 12 years). The indication for this technique was poor acetabular cup coverage of < or = 70% on preoperative templating. In all cases, cementless hemispherical acetabular cups were fixed to the true acetabulum. Additional procedures included soft tissue release in 16 hips and femoral derotational and shortening osteotomies in 12 hips. We evaluated both clinical and radiological results.
The Harris hip scores improved from 57 points preoperatively to 91 points postoperatively. Radiological analysis revealed no aseptic loosening or radiolucent lines around the acetabular cup. Stable bony fixation of the acetabular cup in the true acetabulum was seen in all cases. Acetabular osteolysis was demonstrated in 12 hips. Revision surgery was performed in 6 hips, but there were no complications related to acetabular circumferential medial wall osteotomy.
Circumferential acetabular medial wall osteotomy can provide appropriate positioning and sufficient coverage of the acetabular cup and thus preserve the medial wall thickness in cementless THA without the need for additional bone grafting for the sequelae of septic arthritis of the hip.
我们进行了一项回顾性研究，评估了髋臼周向内侧壁截骨术的结果，该手术旨在为髋关节感染性关节炎后遗症患者提供可靠的非骨水泥半球形髋臼杯固定。
我们评估了 1993 年至 2000 年间因髋关节感染性关节炎后遗症行髋臼周向内侧壁截骨术的 38 例全髋关节置换术（THA）患者，随访时间>或=3 年。平均随访时间为 8.3 年（3 至 12 年）。该技术的适应证为术前模板显示髋臼杯覆盖不良，<或=70%。在所有病例中，非骨水泥半球形髋臼杯均固定于真髋臼。附加手术包括 16 髋软组织松解和 12 髋股骨旋转和缩短截骨术。我们评估了临床和影像学结果。
Harris 髋关节评分从术前的 57 分提高到术后的 91 分。影像学分析显示髋臼杯周围无无菌性松动或透亮线。所有病例均可见髋臼杯在真髋臼中的稳定骨固定。12 髋可见髋臼骨溶解。6 髋行翻修手术，但无与髋臼周向内侧壁截骨术相关的并发症。
髋臼周向内侧壁截骨术可为髋关节感染性关节炎后遗症的非骨水泥 THA 提供适当的髋臼杯定位和充分的覆盖，并保留内侧壁厚度，无需额外植骨。
