Lin Chun-Ru, Chou Hsuan, Luo Chu-An, Chang Shu-Hao
Department of Medical Education, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing Street, Guishan District, Taoyuan City 333423, Taiwan.
School of Medicine, College of Medicine, Fu Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City 24205, Taiwan.
J Pers Med. 2023 Aug 29;13(9):1331. doi: 10.3390/jpm13091331.
Due to the change in the structure of the proximal femur and acetabulum in patients with developmental dysplasia of the hip, total hip arthroplasty (THA) was difficult to perform for surgeons. To elevate the acetabular coverage rate, we developed a technique in the use of a patient-specific instrumentation (PSI) graft in patients with developmental dysplasia of hip (DDH) undergoing surgery. This study aims to evaluate the peri-operative outcomes of THA with PSI graft in patients with DDH. This study recruited 6 patients suffering from Crowe I DDH with secondary Grade IV osteoarthritis. All the patients underwent THA with PSI graft performed by a well-experienced surgeon. Perioperative outcomes included surgical procedures, blood loss during operation, the volume of blood transfusion, length of hospitalization, complications, and the mean difference in hemoglobin levels before and after surgery. All the outcomes analyzed were assessed by mean and standard deviation. The average duration of the surgical procedure was found to be 221.17 min, with an SD of 19.65 min. The mean blood loss during the operation was 733.33 mL, with an SD of 355.90 mL. The mean length of hospital stay was calculated to be 6 days, with an SD of 0.89 days. Furthermore, the mean difference between the pre- and postoperative hemoglobin levels was 2.15, with an SD of 0.99. A total of three patients received 2 units of leukocyte-poor red blood cells (LPR) as an accepted blood transfusion. There were no reported complications observed during the admission and one month after the operation. This study reported the peri-operative outcomes in the patients with DDH who underwent THA with PSI graft. We found that THA with PSI graft would provide a safe procedure without significant complications. We assumed that the PSI graft in THA may increase the coverage rate of the acetabulum, which may increase the graft union rates. Further cohort studies and randomized controlled trials were needed to confirm our findings.
由于发育性髋关节发育不良患者股骨近端和髋臼结构的改变，全髋关节置换术（THA）对外科医生来说难以实施。为提高髋臼覆盖率，我们开发了一种在发育性髋关节发育不良（DDH）患者手术中使用定制化器械（PSI）移植物的技术。本研究旨在评估DDH患者采用PSI移植物行THA的围手术期结果。本研究纳入了6例患有Crowe I型DDH并继发IV级骨关节炎的患者。所有患者均由经验丰富的外科医生采用PSI移植物进行THA。围手术期结果包括手术过程、术中失血、输血量、住院时间、并发症以及手术前后血红蛋白水平的平均差异。所有分析的结果均通过均值和标准差进行评估。发现手术平均时长为221.17分钟，标准差为19.65分钟。术中平均失血量为733.33毫升，标准差为355.90毫升。平均住院时间经计算为6天，标准差为0.89天。此外，术前和术后血红蛋白水平的平均差异为2.15，标准差为0.99。共有3例患者接受了2单位少白细胞红细胞（LPR）作为认可的输血。在入院期间及术后1个月未观察到并发症报告。本研究报告了采用PSI移植物行THA的DDH患者的围手术期结果。我们发现采用PSI移植物的THA是一种安全的手术，无明显并发症。我们推测THA中的PSI移植物可能会提高髋臼覆盖率，这可能会提高移植物的愈合率。需要进一步的队列研究和随机对照试验来证实我们的发现。
