Majewski Martin, Hasler Carol C, Kohler Gregor
Clinic of Orthopaedic Surgery and Traumatology, University Hospital Basel, Switzerland.
J Pediatr Orthop B. 2010 Mar;19(2):135-9. doi: 10.1097/BPB.0b013e3283367b94.
The purpose of the study was to evaluate the ability of arthroscopic mobilization of the hip to improve restricted range of motion after failed conservative therapy (level IV) of patient with aseptic necrosis of the femoral head. We examined 11 patients (eight male, three female). The average age at follow-up was 13 years (8-17 years). All 11 patients suffered from idiopathic femur head necrosis (M. Perthes). A minimum 1-year follow-up revealed an average increase of hip motion of 20 degrees of flexion, 15 degrees of abduction (P=0.007), 30 degrees of adduction (P=0.03), 15 degrees of external rotation, and 20 degrees of internal rotation. Arthroscopic hydraulic hip distension with postoperative physiotherapy in a brace under epidural anesthesia of the hip joint leads to an increased range of motion of the affected hip and allows additional intraarticular assessment of the joint. Whether the arthroscopic findings will alter the treatment and prognosis of future patients has to be established with further studies.
本研究的目的是评估髋关节镜下松动术改善股骨头无菌性坏死患者保守治疗失败（IV级）后活动范围受限的能力。我们检查了11例患者（8例男性，3例女性）。随访时的平均年龄为13岁（8 - 17岁）。所有11例患者均患有特发性股骨头坏死（佩特兹病）。至少1年的随访显示，患侧髋关节活动度平均增加：屈曲20度、外展15度（P = 0.007）、内收30度（P = 0.03）、外旋15度和内旋20度。在髋关节硬膜外麻醉下，通过关节镜液压扩张髋关节并在术后使用支具进行物理治疗，可增加患侧髋关节的活动范围，并允许对关节进行额外的关节内评估。关节镜检查结果是否会改变未来患者的治疗和预后，还有待进一步研究确定。
