Akiho Shunsuke, Kinoshita Koichi, Matsunaga Ayumi, Ishii Satohiro, Seo Hajime, Nishio Jun, Yamamoto Takuaki
Department of Orthopaedic Surgery, Fukuoka University Faculty of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 810-0180, Japan.
Int Orthop. 2018 May;42(5):1029-1034. doi: 10.1007/s00264-017-3656-2. Epub 2017 Oct 10.
Pubic bone nonunion and delayed union are reported as post-operative complications after peri-acetabular osteotomy (PAO). However, few studies have determined the incidence of delayed union using computed tomography (CT) scans. This study aimed to determine the incidence of delayed union at one year after PAO using X-ray and CT scans.
We performed a retrospective review of 150 hips in 132 consecutive patients with acetabular dysplasia who underwent PAO between January 2012 and June 2016 and evaluated 107 hips for which pelvic CT scans taken at one year after PAO were available. Clinical evaluations included age at surgery, weight, body mass index (BMI) and history. Radiographic evaluations were to assess pubic, ischial and iliac delayed union at one year post-operatively.
Based on X-ray analysis, the incidence of delayed union in the pubic, ischial and iliac bones was 11.2% (12 hips), 5.6% (6 hips) and 0% (0 hips), respectively, and20.6% (22 hips), 8.4% (9 hips) and 0% (0 hips), respectively, based on CT scans.
The incidence of delayed union of the pubis and ischium at one year after PAO according to CT scans was higher than that based on X-ray imaging. CT scans are useful in patients with some symptoms at the osteotomy site.
Level III.
耻骨骨不连和延迟愈合被报道为髋臼周围截骨术(PAO)后的术后并发症。然而,很少有研究使用计算机断层扫描(CT)来确定延迟愈合的发生率。本研究旨在通过X线和CT扫描确定PAO术后一年延迟愈合的发生率。
我们对2012年1月至2016年6月期间连续132例髋臼发育不良患者行PAO手术的150个髋关节进行了回顾性分析,并对其中107个髋关节进行了评估,这些髋关节在PAO术后一年有骨盆CT扫描资料。临床评估包括手术年龄、体重、体重指数(BMI)和病史。影像学评估是为了评估术后一年耻骨、坐骨和髂骨的延迟愈合情况。
基于X线分析,耻骨、坐骨和髂骨延迟愈合的发生率分别为11.2%(12个髋关节)、5.6%(6个髋关节)和0%(0个髋关节);基于CT扫描,发生率分别为20.6%(22个髋关节)、8.4%(9个髋关节)和0%(0个髋关节)。
根据CT扫描,PAO术后一年耻骨和坐骨延迟愈合的发生率高于X线成像。对于截骨部位有一些症状的患者,CT扫描很有用。
三级。