Goronzy Jens, Günther Klaus-Peter
UniversitätsCentrum für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Orthopadie (Heidelb). 2023 Apr;52(4):282-292. doi: 10.1007/s00132-023-04354-w. Epub 2023 Mar 9.
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.
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。