Eyb R, Kotz R
Orthopädische Universitätsklinik, Wien.
Orthopade. 1990 Aug;19(4):231-5.
The long-term results of 46 Sugioka osteotomies are presented: In 22 patients no joint replacement had yet been necessary, and 17 hip joints had already been replaced by total hip prostheses. Of the 22 preserved joints, 12 were graded as clinically excellent and good, 10 as fair or poor. The radiological course showed worsening osteoarthritic changes in almost all cases. In the "survival curve" for the Sugioka osteotomy in the group with 17 total hip prostheses the most significant slope can be seen during the first 3 years postoperatively; between 5 and 10 years there are no failures; and then the curve descends again. Fair and poor results are noted most frequently between 6 and 10 years after the operation in the group of 22 patients with no joint replacement. The preoperative extent of necrosis and the radiological stage are the main factors determining the result. Over the years it has been possible to define a narrow spectrum of indications: the greatest benefit is obtained in young, cooperative patients with necrotic sectors of about 90 degrees and good function of the hip joint.
本文展示了46例杉冈截骨术的长期结果:22例患者尚未需要进行关节置换,17个髋关节已被全髋关节假体置换。在保留的22个关节中,12个在临床上评定为优或良,10个为一般或差。放射学检查结果显示,几乎所有病例的骨关节炎变化都在加重。在接受17个全髋关节假体置换的患者组中,杉冈截骨术的“生存曲线”在术后头3年斜率最为显著;5至10年期间无失败病例;之后曲线再次下降。在未进行关节置换的22例患者组中,一般和差的结果最常出现在术后6至10年。术前坏死范围和放射学分期是决定结果的主要因素。多年来,已能够确定一个狭窄的适应证范围:对于年轻、配合良好、坏死区域约90度且髋关节功能良好的患者,获益最大。