Sloan Matthew, Kamath Atul F
Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
J Hip Preserv Surg. 2018 Jan 11;5(1):34-38. doi: 10.1093/jhps/hnx045. eCollection 2018 Jan.
Colonna capsular arthroplasty represents an option for the management of chronic hip dislocation in young patients with dysplasia. In the appropriate patient, modern capsular arthroplasty procedures may provide an opportunity for hip preservation in patients with preserved femoral head cartilage and not appropriate for total hip arthroplasty. Here, we review our experience with surgical dislocation of the hip and capsular arthroplasty in a 27-year-old female with congenital hip dysplasia and chronic superior hip dislocation. Due to inadequate native capsular tissue, a decellularized dermal allograft was used for interposition and capsular arthroplasty augmentation. The femoral head with preserved articular cartilage was reduced into the enlarged native acetabulum using a parachute technique to hold the allograft in position. Post-operatively, the patient was placed in a hip abduction brace and made non-weight bearing for six weeks. A conservative physical therapy protocol was implemented to allow gradual increase in weight bearing and range of motion over the first 12 weeks post-operatively.
科隆纳关节囊成形术是治疗发育异常的年轻患者慢性髋关节脱位的一种选择。对于合适的患者,现代关节囊成形术可为股骨头软骨保留且不适合全髋关节置换术的患者提供保留髋关节的机会。在此,我们回顾了一名27岁先天性髋关节发育不良并慢性髋关节上脱位女性患者行髋关节手术脱位及关节囊成形术的经验。由于自体关节囊组织不足,使用了脱细胞真皮同种异体移植物进行置入和关节囊成形术增强。采用降落伞技术将保留关节软骨的股骨头复位至扩大的髋臼内,以固定同种异体移植物。术后,患者佩戴髋关节外展支具,六周内不负重。实施了保守的物理治疗方案,以便在术后最初12周内逐渐增加负重和活动范围。