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髋臼旋转截骨术联合股骨截骨术治疗髋关节发育不良的长期疗效。

Long-Term Outcomes of Eccentric Rotational Acetabular Osteotomy Combined With Femoral Osteotomy for Hip Dysplasia.

机构信息

Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.

Department of Rehabilitation, Kansai University of Welfare and Sciences, Kashiwara, Osaka, Japan.

出版信息

J Arthroplasty. 2020 Jan;35(1):17-22. doi: 10.1016/j.arth.2019.07.041. Epub 2019 Aug 3.

Abstract

BACKGROUND

This study aimed at investigating the clinical outcomes of eccentric rotational acetabular osteotomy (ERAO) combined with intertrochanteric valgus osteotomy (ITVO) over a period of more than 10 years.

METHODS

This is a case-control study of 39 patients (40 hips) who underwent ERAO combined with ITVO for hip dysplasia (ITVO group). Patients were matched for age, sex, follow-up period, and preoperative joint stage to 78 patients (80 hips) who underwent ERAO alone (ERAO group). We compared the clinical and radiographic outcomes and the survival rates between the groups.

RESULTS

The Harris Hip Score at the final follow-up was significantly lower in the ITVO group than in the ERAO group. The postoperative center edge angle, acetabular head index, and minimum joint space were significantly smaller in the ITVO group than in the ERAO group. The survival rates for the conversion to total hip arthroplasty end point were not significantly different between groups. However, survival rates for the Harris Hip Score < 80 end point were significantly poorer in the ITVO group than in the ERAO group.

CONCLUSION

The long-term results of ERAO combined with ITVO were not satisfactory from a hip function perspective. ERAO combined with ITVO should be indicated in only young active patients with pre-osteoarthritis and initial stages of osteoarthritis.

摘要

背景

本研究旨在探讨偏心旋转髋臼截骨术(ERAO)联合转子间外展截骨术(ITVO)超过 10 年的临床结果。

方法

这是一项病例对照研究,共纳入 39 例(40 髋)接受 ERAO 联合 ITVO 治疗髋关节发育不良的患者(ITVO 组)。将患者按年龄、性别、随访时间和术前关节分期与 78 例(80 髋)单独接受 ERAO 治疗的患者(ERAO 组)进行匹配。比较两组患者的临床和影像学结果以及生存率。

结果

末次随访时,ITVO 组的 Harris 髋关节评分明显低于 ERAO 组。ITVO 组术后中心边缘角、髋臼指数和最小关节间隙明显小于 ERAO 组。两组患者的全髋关节置换术终点转换生存率无显著差异。然而,Harris 髋关节评分<80 终点的生存率在 ITVO 组明显低于 ERAO 组。

结论

从髋关节功能的角度来看,ERAO 联合 ITVO 的长期结果并不令人满意。ERAO 联合 ITVO 仅应适用于有前骨关节炎和早期骨关节炎的年轻、活跃的患者。

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