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关节镜下矫正治疗股骨头特发性骨坏死合并凸轮撞击症1例报告

Arthroscopic correction for concomitant cam impingement in a patient with idiopathic osteonecrosis of the femoral head: A case report.

作者信息

Fukui Kiyokazu, Kaneuji Ayumi, Matsumoto Tadami

机构信息

Department of Orthopaedic Surgery, Kanazawa Medical University, Kahoku-gun, Japan.

Department of Orthopaedic Surgery, Kanazawa Medical University, Kahoku-gun, Japan.

出版信息

Int J Surg Case Rep. 2016;19:154-8. doi: 10.1016/j.ijscr.2015.12.021. Epub 2015 Dec 22.

Abstract

A 53-year-old man presented with pain in the right hip. Radiological examination showed idiopathic osteonecrosis of the femoral head (ONFH) combined with a cam lesion. Findings on physical examination were consistent for femoroacetabular impingement. At surgery, we performed isolated arthroscopic correction for the cam lesion but did not use other treatment options such as hip arthroplasty or osteotomies for the ONFH. At the latest follow-up evaluation 3 years after surgery, findings indicted a satisfactory outcome, with a Harris hip score of 93.2 (compared with 76.4 before surgery), no joint-space narrowing, and no collapse of the femoral head. It is important to accurately diagnose the status of idiopathic ONFH and to consider another possible pathogenesis when a patient with idiopathic ONFH has hip pain even without femoral-head collapse.

摘要

一名53岁男性因右髋疼痛就诊。影像学检查显示为股骨头缺血性坏死(ONFH)合并凸轮病变。体格检查结果与股骨髋臼撞击症相符。手术中,我们仅对凸轮病变进行了关节镜下矫正,未对ONFH采用髋关节置换术或截骨术等其他治疗方案。在术后3年的最新随访评估中,结果显示预后良好,Harris髋关节评分为93.2(术前为76.4),无关节间隙变窄,股骨头无塌陷。对于特发性ONFH患者,即使股骨头未塌陷但出现髋部疼痛时,准确诊断其病情并考虑其他可能的发病机制非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe6/4756222/19106e439b19/gr1.jpg

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