Department of Orthopaedics and Trauma, Royal Adelaide Hospital and the Discipline of Orthopaedics and Trauma, University of Adelaide, Level 4 Bice Building, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia.
Int Orthop. 2012 May;36(5):921-5. doi: 10.1007/s00264-011-1347-y. Epub 2011 Sep 7.
The aim of this study was to determine whether a complex surgical procedure such as peri-acetabular osteotomy could be safely learnt by using a programme involving mentoring by a distant expert. To determine this, we examined the incidence of intra-operative complications, the acetabulum correction achieved, the late incidence of re-operation and progressive degenerative arthritis.
Between 1992 and 2004, peri-acetabular osteotomy was performed in 26 hips in 23 patients. The median follow-up was ten (5-17) years. The median age of the patients at operation was 28 (14-41) years. Clinical outcomes were reported and radiographic results were determined by an independent expert.
There were no intra-articular osteotomies, sciatic nerve injuries, hingeing deformities or vascular injuries. There was one ischial nonunion. The lateral centre-edge angle improved from a median 4° pre-operatively to 25°. One revision osteotomy, one osteectomy and three total hip replacements were required, two for progression of osteoarthritis.
The programme of mentoring was successful in that there was a low incidence of the major intra-operative complications that are often reported during the learning curve period and the acetabular corrections achieved were similar to the originators.
本研究旨在确定复杂的髋臼周围截骨术是否可以通过专家远程指导的培训项目安全地学习。为此，我们检查了术中并发症的发生率、髋臼矫正的效果、晚期再次手术的发生率和进行性退行性关节炎的发生率。
1992 年至 2004 年间，23 名患者的 26 髋接受了髋臼周围截骨术。中位随访时间为 10 年（5-17 年）。患者手术时的中位年龄为 28 岁（14-41 岁）。报告了临床结果，并由独立专家确定放射学结果。
没有发生关节内截骨、坐骨神经损伤、铰链畸形或血管损伤。有一例坐骨不愈合。外侧中心边缘角从术前的中位数 4°改善到 25°。需要进行 1 次翻修截骨术、1 次骨切除术和 3 次全髋关节置换术，其中 2 次是为了进展性骨关节炎。
指导方案是成功的，因为在学习曲线期间，术中主要并发症的发生率较低，髋臼矫正效果与原始作者相似。
