Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
Orthop Surg. 2009 Aug;1(3):212-5. doi: 10.1111/j.1757-7861.2009.00034.x.
To summarize our surgical experience of release and balance of soft tissues around the hip in total hip arthroplasty (THA) for patients with adult dysplasia of the hip (ADH).
From January 2001 to January 2006, 29 adult patients with dysplastic hips (31 hips) were included in this study. Among them, there were 19 women and 10 men, aged from 38 to 65 years. According to the Crowe classification system, there were 8 type I, 12 type II, 6 type III and 5 type IV. THA was performed via a lateral approach. All acetabular cups were reconstructed at the original anatomic location through soft tissue releasing around the hip to restore limb length, and techniques of balance of soft tissue were applied to extend the strength of the hip abductor and improve its function.
All patients had restoration of limb length (range, 1.5-4.5 cm). One postoperative dislocation occurred due to slight enlargement of the angle of abduction of the acetabulum. At 1.5-year follow-up (mean, 3.2 years) in 29 patients, the Harris score had increased from 42.6 preoperatively to 85.4. All hips were pain free with good function.
In order to restore the anatomic structure and physiologic function of the affected hip, the technique of release and balance of soft tissues around the hip should be applied cautiously in arthroplasty of ADH.
总结我们在成人髋关节发育不良（ADH）全髋关节置换术中松解和平衡髋关节周围软组织的手术经验。
2001 年 1 月至 2006 年 1 月，我们对 29 例成人髋关节发育不良患者（31 髋）进行了研究。其中女性 19 例，男性 10 例，年龄 38 ～ 65 岁。根据 Crowe 分型系统，Ⅰ型 8 髋，Ⅱ型 12 髋，Ⅲ型 6 髋，Ⅳ型 5 髋。手术采用外侧入路。通过髋关节周围软组织松解来恢复肢体长度，所有髋臼杯均在原解剖位置重建，并应用软组织平衡技术来增强髋关节外展肌的力量，改善其功能。
所有患者肢体长度均得到恢复（范围 1.5 ～ 4.5cm）。1 例术后发生轻度髋臼外展角增大导致的脱位。29 例患者获得 1.5 年（平均 3.2 年）随访，Harris 评分由术前的 42.6 分提高至 85.4 分。所有髋关节均无痛，功能良好。
为了恢复髋关节的解剖结构和生理功能，在 ADH 的关节置换术中应谨慎应用髋关节周围软组织松解和平衡技术。
