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高位先天性髋关节脱位:单侧与双侧股骨干横行短缩截骨全髋关节置换术比较。

High-Riding Congenital Hip Dislocation: THA With Unilateral vs Bilateral Transverse Femoral Shortening Osteotomy.

机构信息

Nisantasi Ortopedi Merkezi, Istanbul, Turkey.

Ortopediatri Clinic, Istanbul, Turkey.

出版信息

J Arthroplasty. 2018 May;33(5):1432-1436. doi: 10.1016/j.arth.2017.11.067. Epub 2017 Dec 8.

Abstract

BACKGROUND

We argue that 1-stage bilaterally total hip arthroplasty (THA) could be acceptable in bilateral coxarthrosis because of high-riding developmental dysplasia of the hip (DDH).

METHODS

Sixty-nine cases (51 patients) of high-riding DDH in patients who underwent THA from 2010 to 2013 were reviewed. Patients were divided into 2 groups: unilateral (group 1) and 1-stage bilateral surgery (group 2). The clinical measurements were the visual analog scale and Harris Hip Score.

RESULTS

The average follow-up was 37.3 months for group 1 and 38.8 months for group 2. The hospital stay time was 5.2 days in group 1 and 6.2 days in group 2 (P = .334). The mean Harris Hip Score and visual analog scale score were improved significantly after surgery for both groups, and there was no statistically significant difference (P = .988). There was no difference between groups 1 and 2 in terms of complications (P = .137).

CONCLUSION

Our data confirm that 1-stage bilateral transverse osteotomy with THA is an effective method as unilateral and it does not increase the length of patients' hospital stays and features a low risk of postoperative complications in the treatment of patients with high-riding DDH.

摘要

背景

我们认为,对于高位发育性髋关节发育不良(DDH)的双侧髋关节骨关节炎患者,1 期双侧全髋关节置换术(THA)可能是可行的。

方法

回顾 2010 年至 2013 年接受 THA 的高位 DDH 患者 69 例(51 例患者)。患者分为两组:单侧组(第 1 组)和 1 期双侧手术组(第 2 组)。临床测量包括视觉模拟评分和 Harris 髋关节评分。

结果

第 1 组的平均随访时间为 37.3 个月,第 2 组为 38.8 个月。第 1 组的住院时间为 5.2 天,第 2 组为 6.2 天(P=0.334)。两组术后髋关节评分和视觉模拟评分均显著改善,差异无统计学意义(P=0.988)。两组并发症无差异(P=0.137)。

结论

我们的数据证实,1 期双侧横断截骨 THA 是一种有效的治疗高位 DDH 的方法,与单侧手术相比,它不会增加患者的住院时间,且术后并发症的风险较低。

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