Sen Cengiz, Bilsel Kerem, Elmadag Mehmet, Gunes Taner, Saygi Baransel
Capa Medical Faculty, Istanbul University, Istanbul - Turkey.
Orthopaedic and Traumatology Department, Bezmialem Vakif University, Istanbul - Turkey.
Hip Int. 2016 Jul 25;26(4):360-6. doi: 10.5301/hipint.5000357. Epub 2016 May 26.
Total hip replacement in patients with developmental dysplasia of the hip (DDH) is a difficult technical procedure for surgeons to perform because of the potential for these patients to have severe anomalies in their bones and soft tissues.
We performed acetabuloplasty in 54 hips from 44 patients by reaming the posterior wall of the native acetabulum and medialising the acetabular component to restore the anatomic centre of hip rotation using a small cup without bone grafting. Median time to post-surgery follow-up was 5 (range 2-14) years.
Prosthetic survival rates in patients after 2 and 5 years post hip replacement were 93% (50/54) and 89% (48/54), respectively. 4 patients required early revision because of malposition and instability of the acetabular cup. 3 patients with Crowe type IV dislocations had transient sciatic nerve palsy and 3 had deep vein thrombosis.
Placement of the acetabular shell using posterior bone stock to provide normal hip rotation is a successful alternative technique for acetabuloplasty in patients with DDH.
对于外科医生而言，髋关节发育不良（DDH）患者的全髋关节置换术是一项技术难度较大的手术，因为这些患者的骨骼和软组织可能存在严重异常。
我们对44例患者的54个髋关节进行了髋臼成形术，通过扩锉天然髋臼后壁并将髋臼假体组件向内侧移位，使用小髋臼杯恢复髋关节旋转的解剖中心，未进行植骨。术后随访的中位时间为5年（范围2 - 14年）。
髋关节置换术后2年和5年患者的假体生存率分别为93%（50/54）和89%（48/54）。4例患者因髋臼杯位置不当和不稳定需要早期翻修。3例Crowe IV型脱位患者出现短暂性坐骨神经麻痹，3例出现深静脉血栓形成。
利用髋臼后方骨量来放置髋臼杯以实现正常髋关节旋转，是DDH患者髋臼成形术的一种成功替代技术。
