Rosenstein Alexander D, Diaz Roberto J
Department of Orthopaedic Surgery, University of TexasHealth Science Center, 6431 Fannin Street, Houston,TX 77030, USA.
Am J Orthop (Belle Mead NJ). 2011 Feb;40(2):87-91.
Conditions that adversely affect a child's hip alignment, joint congruity, or articular surfaces often result in joint destruction associated with pain and motion limitation later in life. The usual culprits are developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis, Legg-Calvé-Perthes disease, juvenile rheumatoid arthritis, infection, trauma, and neoplasm. In this review, we address DDH, the most common cause of secondary osteoarthritis of the hip. Symptomatic sequelae of DDH present challenges for total hip arthroplasty, including excessive proximal femoral anteversion, narrowing of the medullary canal, acetabular anteversion, verticality, hypoplasia and incongruity, pseudoacetabulum, and neurovascular shortening. Presiding corrective femoral and/or acetabular osteotomies, as well as retained hardware, further complicate total hip arthroplasty. This review emphasizes evaluation of hip morphology while considering reconstructive techniques and implants.
那些对儿童髋关节对线、关节一致性或关节面产生不利影响的病症，常常会在日后导致与疼痛和活动受限相关的关节破坏。常见的病因包括发育性髋关节发育不良（DDH）、股骨头骨骺滑脱、Legg-Calvé-Perthes病、幼年类风湿关节炎、感染、创伤和肿瘤。在本综述中，我们探讨DDH，这是髋关节继发性骨关节炎最常见的病因。DDH的症状性后遗症给全髋关节置换术带来了挑战，包括股骨近端过度前倾、髓腔狭窄、髋臼前倾、垂直、发育不全和不一致、假髋臼以及神经血管缩短。先行的股骨和/或髋臼截骨术以及留存的内固定装置，使全髋关节置换术进一步复杂化。本综述强调在考虑重建技术和植入物时对髋关节形态进行评估。
