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[髋关节发育不良:年龄、关节病及伴发疾病对治疗结果有何影响?]

[Hip dysplasia: What influence do age, arthrosis and concomitant diseases have on the treatment result?].

作者信息

Goronzy Jens, Günther Klaus-Peter

机构信息

UniversitätsCentrum für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.

出版信息

Orthopadie (Heidelb). 2023 Apr;52(4):282-292. doi: 10.1007/s00132-023-04354-w. Epub 2023 Mar 9.

DOI:10.1007/s00132-023-04354-w
PMID:36894594
Abstract

Pelvic osteotomies are an established treatment for symptomatic adult hip dysplasia with a promising long-term outcome. Results depend not only on the achieved acetabular reorientation but also on patient-factors like preoperative joint condition (degree of osteoarthritis and joint congruency) and age. Additionally, the diagnosis and appropriate therapy of impingement-associated hip deformities is essential in order to achieve good mid- and long-term outcomes. The influence of chondrolabral pathology on the outcome of pelvic osteotomies is not yet defined. Symptomatic patients with residual dysplasia after previous pelvic or acetabular osteotomies can benefit from an additional osteotomy, although results can be worse in comparison to prior unoperated joints. Obesity can make surgery more demanding and increases the complication profile of PAO, although it has no influence on the postoperative outcome. Regarding the overall prognosis after an osteotomy, the consideration of combined risk factors is superior to the concentration on individual factors alone.

摘要

骨盆截骨术是治疗有症状的成年髋关节发育不良的既定方法,具有良好的长期预后前景。结果不仅取决于髋臼重新定向的实现程度,还取决于患者因素,如术前关节状况(骨关节炎程度和关节一致性)和年龄。此外,为了获得良好的中长期结果,对撞击相关髋关节畸形的诊断和适当治疗至关重要。髋臼盂唇病理对骨盆截骨术结果的影响尚未明确。先前骨盆或髋臼截骨术后仍有发育不良症状的患者可从额外的截骨术中获益,尽管与之前未手术的关节相比,结果可能更差。肥胖会使手术要求更高,并增加髋臼周围截骨术的并发症发生率,尽管它对术后结果没有影响。关于截骨术后的总体预后,综合考虑风险因素优于仅关注个体因素。

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Knee Surg Sports Traumatol Arthrosc. 2023 Jun;31(6):2090-2102. doi: 10.1007/s00167-022-07108-x. Epub 2022 Aug 16.
2
Hip arthroscopy after periacetabular osteotomy for acetabular dysplasia - incidence and clinical outcome.髋臼发育不良行髋臼周围截骨术后髋关节镜检查的发生率及临床疗效。
BMC Musculoskelet Disord. 2022 Jul 12;23(1):659. doi: 10.1186/s12891-022-05625-x.
3
Arthroscopic Treatment of Mild/Borderline Hip Dysplasia with Concomitant Femoroacetabular Impingement-Literature Review.
关节镜治疗伴有股骨髋臼撞击症的轻度/临界性髋关节发育不良——文献综述
Curr Rev Musculoskelet Med. 2022 Aug;15(4):300-310. doi: 10.1007/s12178-022-09765-4. Epub 2022 Jun 16.
4
Rate of Return to Work After Periacetabular Osteotomy and Its Influencing Factors.髋臼周围截骨术后的重返工作率及其影响因素。
J Bone Joint Surg Am. 2022 Apr 20;104(8):732-738. doi: 10.2106/JBJS.21.00548. Epub 2022 Jan 18.
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Survival of the dysplastic hip after periacetabular osteotomy: a meta-analysis.髋臼周围截骨术后发育不良髋关节的存活率:一项荟萃分析。
Hip Int. 2023 Mar;33(2):306-312. doi: 10.1177/11207000211048425. Epub 2021 Sep 27.
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J Arthroplasty. 2021 Oct;36(10):3388-3391. doi: 10.1016/j.arth.2021.05.029. Epub 2021 May 25.
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