Hiroshima Prefectural Rehabilitation Center, Higashi-Hiroshima, Japan.
Department of Orthopaedic Surgery, Hiroshima University, Higashi-Hiroshima, Japan.
Bone Joint J. 2019 Apr;101-B(4):390-395. doi: 10.1302/0301-620X.101B4.BJJ-2018-1200.R1.
The aim of this study was to report the long-term results of rotational acetabular osteotomy (RAO) for symptomatic hip dysplasia in patients aged younger than 21 years at the time of surgery.
We evaluated 31 patients (37 hips) aged younger than 21 years at the time of surgery retrospectively. There were 29 female and two male patients. Their mean age at the time of surgery was 17.4 years (12 to 21). The mean follow-up was 17.9 years (7 to 30). The RAO was combined with a varus or valgus femoral osteotomy or a greater trochanteric displacement in eight hips, as instability or congruence of the hip could not be corrected adequately using RAO alone.
The mean Merle d'Aubigné clinical score improved significantly from 15.4 to 17.2 (p < 0.0001). The mean centre-edge (CE) angle improved from -2.6° to 26°, the mean acetabular roof angle improved from 3.0° to 5.2°, and the mean head lateralization index improved from 0.68 to 0.62. Progression of radiological osteoarthritis (OA) was seen in seven hips, but no patient underwent total hip arthroplasty.
RAO is an effective form of correction for a severely dysplastic hip in adolescent and young adult patients. Cite this article: Bone Joint J 2019;101-B:390-395.
本研究旨在报告旋转髋臼截骨术（RAO）治疗手术时年龄小于 21 岁的症状性髋关节发育不良患者的长期结果。
我们回顾性评估了 31 例（37 髋）手术时年龄小于 21 岁的患者。其中 29 例为女性，2 例为男性。手术时的平均年龄为 17.4 岁（12 岁至 21 岁）。平均随访时间为 17.9 年（7 年至 30 年）。RAO 联合股骨内旋或外旋截骨或大转子移位术适用于 8 髋，因为单独使用 RAO 无法充分纠正髋关节的不稳定或不匹配。
Merle d'Aubigné 临床评分从 15.4 分显著提高至 17.2 分（p < 0.0001）。中心边缘（CE）角平均从-2.6°改善至 26°，髋臼顶角度平均从 3.0°改善至 5.2°，头部外侧化指数平均从 0.68 改善至 0.62。7 髋出现影像学进展性骨关节炎（OA），但无一例患者接受全髋关节置换术。
RAO 是青少年和年轻成人严重髋关节发育不良患者的有效矫正方法。
