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从出生到关节置换术的发育性髋关节发育不良:明确指征与新争议

Developmental Dysplasia of the Hip From Birth to Arthroplasty: Clear Indications and New Controversies.

作者信息

Rosenfeld Scott B, Weinstein Stuart L, Schoenecker Jonathan G, Matheney Travis

出版信息

Instr Course Lect. 2019;68:319-336.

Abstract

Developmental dysplasia of the hip is the all-encompassing term used to describe the wide spectrum of disorders of the development of the hip that manifest in various forms and at different ages. Developmental dysplasia of the hip often evolves over time because the structures of the hip are normal during embryogenesis but gradually become abnormal. Such variability in pathology is associated with a similarly wide range in management options and recommendations aimed at preventing hip joint arthrosis. These options may be instituted at any time between birth and adulthood as techniques aimed at preserving the native hip or replacing the arthritic hip. Many of these management options are clearly indicated and considered standard practice. However, with the evolution of the understanding of hip biomechanics, better knowledge of the long-term outcomes of hip joint-preserving surgeries, and ever-improving technology influencing hip arthroplasty come new controversies, especially whether to preserve or replace the mature hip.

摘要

发育性髋关节发育不良是一个综合性术语,用于描述髋关节发育过程中出现的各种病症,这些病症以不同形式在不同年龄表现出来。发育性髋关节发育不良通常会随着时间的推移而演变,因为髋关节结构在胚胎发育过程中是正常的,但会逐渐变得异常。这种病理变化的多样性与旨在预防髋关节骨关节炎的管理选择和建议的广泛范围相关。这些选择可以在出生至成年之间的任何时间实施,作为旨在保留天然髋关节或置换患有关节炎的髋关节的技术。其中许多管理选择已明确指出并被视为标准做法。然而,随着对髋关节生物力学理解的演变、对保留髋关节手术长期结果的更深入了解以及影响髋关节置换术的技术不断进步,出现了新的争议,特别是对于成熟髋关节是保留还是置换。

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