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既往骨盆或股骨近端截骨术对发育性髋关节病患者全髋关节置换术疗效的影响。

The effect of previous pelvic or proximal femoral osteotomy on the outcomes of total hip arthroplasty in patients with dysplastic coxarthrosis.

作者信息

Erdoğan Fahri, Can Ata

机构信息

Nişantaşı Orthopaedic Center, İstanbul, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2020 Jan;54(1):74-82. doi: 10.5152/j.aott.2020.01.7.

Abstract

OBJECTIVE

This study aimed to evaluate whether a history of a pelvic osteotomy or proximal femoral osteotomy compromises the outcomes of total hip arthroplasty in patients with dysplastic coxarthrosis.

METHODS

The results of total hip arthroplasty in 240 hips of 172 patients without previous pelvic osteotomy or proximal femoral osteotomy were compared to 118 hips of 88 patients with a previous pelvic osteotomy or proximal femoral osteotomy (osteotomy group). Technical difficulties and rates of complications during surgery, operative time, estimated blood loss, rates of postoperative complications, and pre- and postoperative Harris Hip Scores and visual analog scale pain scores were compared between the two groups.

RESULTS

In the osteotomy, the rate of complications was higher and the operative time was longer. The estimated blood loss was also higher, and the latest follow-up Harris Hip Scores and visual analog scale pain scores were worse in this group. Total hip arthroplasty was more demanding and the revision rate was higher in the osteotomy group (six vs four revisions).

CONCLUSION

Our data showed that a previous history of pelvic osteotomy or proximal femoral osteotomy compromised the clinical outcomes of subsequent total hip arthroplasty and is related to an increased rate of complications, prolonged operative time, and increased amount of blood loss.

LEVEL OF EVIDENCE

Level III, Therapeutic Study.

摘要

目的

本研究旨在评估骨盆截骨术或股骨近端截骨术史是否会影响发育性髋关节病患者全髋关节置换术的疗效。

方法

将172例未曾接受过骨盆截骨术或股骨近端截骨术患者的240髋全髋关节置换术结果,与88例曾接受过骨盆截骨术或股骨近端截骨术患者的118髋(截骨术组)进行比较。比较两组手术中的技术难度和并发症发生率、手术时间、估计失血量、术后并发症发生率以及术前和术后的Harris髋关节评分和视觉模拟量表疼痛评分。

结果

在截骨术组中,并发症发生率更高,手术时间更长。估计失血量也更多,该组最新随访时的Harris髋关节评分和视觉模拟量表疼痛评分更差。全髋关节置换术在截骨术组中要求更高,翻修率也更高(6例翻修对比4例翻修)。

结论

我们的数据表明,既往骨盆截骨术或股骨近端截骨术史会影响后续全髋关节置换术的临床疗效,并与并发症发生率增加、手术时间延长和失血量增加有关。

证据水平

三级,治疗性研究。

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