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成人发育性髋关节发育不良治疗中的当前手术技术

Current Surgical Techniques in the Treatment of Adult Developmental Dysplasia of the Hip.

作者信息

Dhaliwal Anand S, Akhtar Muzammil, Razick Daniel I, Afzali Arya, Wilson Ethan, Nedopil Alexander J

机构信息

College of Medicine, Californa Northstate University, Elk Grove, CA 95757, USA.

Orthopädische Klinik König-Ludwig-Haus, Lehrstuhl für Orthopädie der Universität Würzburg, 97074 Würzburg, Germany.

出版信息

J Pers Med. 2023 Jun 1;13(6):942. doi: 10.3390/jpm13060942.

Abstract

The surgical protocols currently used for the treatment of developmental dysplasia of the hip (DDH) are varied, with sufficient differences in clinical outcomes that warrant a review of the role of practicing orthopedic surgeons. This paper aims to summarize the current novel techniques within the realm of surgical treatment for adult DDH, thus serving as a guide to surgeons looking to quickly familiarize themselves with available techniques. We performed computer systematic literature searches of the Embase and PubMed databases from 2010 to 2 April 2022. Study parameters as well as their respective patient reported outcomes (PROMs) were described in detail and compiled into diagrams. Two novel techniques were identified for the treatment of borderline or low-grade DDH. Six techniques which included modifications to the Bernese periacetabular osteotomy (PAO) were identified for the treatment of symptomatic DDH. Three techniques which include combinations of arthroscopy and osteotomy were identified for the treatment of DDH with concomitant hip pathologies such as cam deformities. Finally, six techniques, all of which are modifications to total hip arthroplasty (THA), were identified for the treatment of high-grade DDH. The techniques detailed in this review therefore equip surgeons with the necessary knowledge to improve outcomes in patients with varying degrees of DDH.

摘要

目前用于治疗发育性髋关节发育不良(DDH)的手术方案多种多样,临床结果存在足够差异,这使得有必要对骨科执业医师的作用进行审视。本文旨在总结成人DDH手术治疗领域内当前的新技术,从而为希望快速熟悉现有技术的外科医生提供指导。我们对2010年至2022年4月2日的Embase和PubMed数据库进行了计算机系统文献检索。详细描述了研究参数及其各自的患者报告结局(PROMs),并整理成图表。确定了两种治疗临界或低度DDH的新技术。确定了六种包括对伯尔尼髋臼周围截骨术(PAO)进行改良的技术,用于治疗有症状的DDH。确定了三种包括关节镜检查和截骨术联合应用的技术,用于治疗伴有髋关节病变(如凸轮畸形)的DDH。最后,确定了六种均为全髋关节置换术(THA)改良术式的技术,用于治疗高度DDH。因此,本综述中详细介绍的技术为外科医生提供了必要的知识,以改善不同程度DDH患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da0/10300991/815e02acea78/jpm-13-00942-g001.jpg

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