Tanaka Takeyuki, Moro Toru, Takatori Yoshio, Oshima Hirofumi, Ito Hideya, Sugita Naohiko, Mitsuishi Mamoru, Tanaka Sakae
Orthopaedic Surgery, Sensory and Motor System Medicine, Surgical Sciences, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Int Orthop. 2018 Nov;42(11):2527-2534. doi: 10.1007/s00264-018-3851-9. Epub 2018 Feb 26.
Rotational acetabular osteotomy is a type of pelvic osteotomy that involves rotation of the acetabular bone to improve the bony coverage of the femoral head for patients with acetabular dysplasia. Favourable post-operative long-term outcomes have been reported in previous studies. However, there is a paucity of published data regarding three-dimensional bony coverage. The present study investigated the three-dimensional bony coverage of the acetabulum covering the femoral head in hips before and after rotational acetabular osteotomy and in normal hips.
The computed tomography data of 40 hip joints (12 joints before and after rotational acetabular osteotomy; 16 normal joints) were analyzed. The three-dimensional bony coverage of each joint was evaluated using original software.
The post-operative bony coverage improved significantly compared with pre-operative values. In particular, the anterolateral aspect of the acetabulum tended to be dysplastic in patients with acetabular dysplasia compared to those with normal hip joints. However, greater bony coverage at the anterolateral aspect was obtained after rotational acetabular osteotomy. Meanwhile, the results of the present study may indicate that the bony coverage in the anterior aspect may be excessive.
Three-dimensional analysis indicated that rotational acetabular osteotomy achieved favorable bony coverage. Further investigations are necessary to determine the ideal bony coverage after rotational acetabular osteotomy.
髋臼旋转截骨术是一种骨盆截骨术，通过旋转髋臼骨来改善髋臼发育不良患者股骨头的骨覆盖。既往研究报道了良好的术后长期疗效。然而，关于三维骨覆盖的已发表数据较少。本研究调查了髋臼旋转截骨术前后髋关节以及正常髋关节中髋臼覆盖股骨头的三维骨覆盖情况。
分析了40个髋关节的计算机断层扫描数据（12个髋臼旋转截骨术前后的关节；16个正常关节）。使用原始软件评估每个关节的三维骨覆盖情况。
术后骨覆盖与术前值相比有显著改善。特别是，与正常髋关节患者相比，髋臼发育不良患者髋臼的前外侧部分往往发育异常。然而，髋臼旋转截骨术后前外侧部分获得了更大的骨覆盖。同时，本研究结果可能表明前侧的骨覆盖可能过度。
三维分析表明髋臼旋转截骨术实现了良好的骨覆盖。需要进一步研究以确定髋臼旋转截骨术后的理想骨覆盖情况。
