Zhang L, Lu X
Department of Orthopedics, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
Acta Chir Orthop Traumatol Cech. 2019;86(2):93-100.
Various surgical treatments for osteoarthritis (OA) secondary to hip dysplasia have been reported in the literature. According to the position of the arthroplasty cup, generally they could be divided into two groups: the primary rotational center (PRC) group and the high hip center (HHC) group. Some surgeons prefer the HHC technique. Without doubt it is less demanding, but several concerns exist against the long-term stability. When restoring the PRC, since the dysplastic acetabulum is usually shallower and underdeveloped, bone grafts or other biosynthetic materials are usually needed for the ideal fixation. The source of grafts is quite wide. For example, they could be autologous (femoral head, iliac crest) or homologous (allografts), bulky or morselized. Medial wall protrusion technique, as well as other materials like oblong cup, porous titanium and tantalum augments, 3D printed implants could also be an option. Except these, reports are also divided into cemented and cementless techniques. Therefore, no technique is perfect and clinical results so far are quite variable. We think it's necessary to compare the pros and cons between each other. Key words:hip dysplasia, total hip replacement, cup position, secondary osteoarthritis.
文献中报道了多种针对髋关节发育不良继发骨关节炎(OA)的外科治疗方法。根据人工关节杯的位置,通常可将其分为两组:原发性旋转中心(PRC)组和高髋关节中心(HHC)组。一些外科医生更喜欢HHC技术。毫无疑问,它的要求较低,但长期稳定性存在一些问题。恢复PRC时,由于发育不良的髋臼通常较浅且发育不全,理想的固定通常需要骨移植或其他生物合成材料。移植材料的来源相当广泛。例如,它们可以是自体的(股骨头、髂嵴)或同种异体的(同种异体移植物),块状或碎粒状。内壁突出技术,以及其他材料如椭圆形杯、多孔钛和钽增强物、3D打印植入物也可以是一种选择。除此之外,报道也分为骨水泥固定和非骨水泥固定技术。因此,没有一种技术是完美的,目前的临床结果差异很大。我们认为有必要相互比较优缺点。关键词:髋关节发育不良、全髋关节置换、髋臼位置、继发性骨关节炎