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髋关节手术脱位治疗髋关节滑膜软骨瘤病。

Surgical hip dislocation for treatment of synovial chondromatosis of the hip.

机构信息

Department of Orthopedics, the First People's Hospital of Changzhou, 185 Ju Qian Road, Changzhou, 213000, China.

出版信息

Int Orthop. 2021 Nov;45(11):2819-2824. doi: 10.1007/s00264-021-05045-x. Epub 2021 Apr 20.

Abstract

PURPOSE

In the present study, we aimed to evaluate the clinical outcomes of surgical hip dislocation in patients with synovial chondromatosis (SC) of the hip.

METHODS

Seven patients with primary SC of the hip treated with open synovectomy and removal of loose bodies by surgical hip dislocation from 2016 to 2019 were retrospectively reviewed. All patients had numerous and widespread loose bodies based on pre-operative images, including routine radiographs, CT, and MRI. The visual analog scale (VAS) score and Harris hip score (HHS) were collected and analyzed before and after surgery. The post-operative radiographs were reviewed to evaluate disease recurrence and osteoarthritis progression.

RESULTS

The mean operative time was 61 minutes (range, 42-75 min). An average of 33 loose bodies in each patient (range, 16-67) was removed, and extra-articular pathology was found in one patient. Patients were followed up for a mean duration of 30 months (range, 18-42 months). The average VAS scores were decreased from 3.7 (range, 2-6) pre-operatively to 0.9 (range, 0-2) at the last follow-up, and the HHS was improved from 60.1 (range, 50-73) to 90.1 (range, 82-95). All results demonstrated significant improvements (P < 0.05). Post-operative radiographs showed no recurrence, osteoarthritis progression, or osteonecrosis of the femoral head in all hips.

CONCLUSIONS

Surgical hip dislocation was a practical approach for managing both intra-articular and extra-articular pathologic lesions around the hip. It was an effective treatment for SC of the hip with short surgical time, good joint functions, a lower recurrence rate, and few complications.

摘要

目的

本研究旨在评估髋关节滑膜软骨瘤病(SC)患者行髋关节脱位手术的临床疗效。

方法

回顾性分析 2016 年至 2019 年间采用髋关节切开滑膜切除术和游离体切除术治疗的 7 例原发性髋关节 SC 患者。所有患者术前影像学检查(包括常规 X 线片、CT 和 MRI)显示有大量广泛的游离体。收集并分析术前和术后视觉模拟评分(VAS)和髋关节 Harris 评分(HHS)。术后评估影像学检查以评估疾病复发和骨关节炎进展情况。

结果

手术时间平均为 61 分钟(42-75 分钟)。每位患者平均切除 33 个游离体(16-67 个),1 例患者存在关节外病变。患者平均随访 30 个月(18-42 个月)。平均 VAS 评分从术前的 3.7(2-6)分降至末次随访时的 0.9(0-2)分,HHS 从 60.1(50-73)分提高至 90.1(82-95)分。所有结果均有显著改善(P<0.05)。所有髋关节术后影像学检查未见复发、骨关节炎进展或股骨头坏死。

结论

髋关节脱位术是一种治疗髋关节周围关节内和关节外病变的实用方法。对于髋关节 SC,该术式手术时间短、关节功能良好、复发率低、并发症少,是一种有效的治疗方法。

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