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儿童髋关节疾病后遗症的全髋关节置换术前规划:聚焦发育性髋关节发育不良

Total hip arthroplasty preoperative planning for childhood hip disorders' sequelae: Focus on developmental dysplasia of the hip.

作者信息

Gill Saran S, Pace Valerio

机构信息

Faculty of Medicine, Imperial College London, London SW7 2AZ, United Kingdom.

Department of Trauma and Orthopaedics, AOSP Terni, Terni 05100, Italy.

出版信息

World J Orthop. 2024 Dec 18;15(12):1112-1117. doi: 10.5312/wjo.v15.i12.1112.

Abstract

Developmental dysplasia of the hip (DDH) poses significant challenges in both childhood and adulthood, affecting up to 10 per 1000 live births in the United Kingdom and United States. While newborn screening aims to detect DDH early, missed diagnoses can lead to severe complications such as hip dysplasia and early onset osteoarthritis in adults. Treatment options range from less invasive procedures like hip-preserving surgery to more extensive interventions such as total hip arthroplasty (THA), depending on the severity of the condition. Preoperative planning plays a critical role in optimizing surgical outcomes for DDH patients undergoing THA. This includes accurate imaging modalities, precise measurement of acetabular bone stock, assessment of femoral head subluxation, and predicting prosthesis size and leg length discrepancy. Recent advancements artificial intelligence and machine learning offer promising tools to enhance preoperative planning accuracy. However, challenges remain in validating these technologies and integrating them into clinical practice. This editorial highlights the importance of ongoing research to refine preoperative strategies and improve outcomes in DDH management through evidence-based approaches and technological innovations.

摘要

髋关节发育不良(DDH)在儿童期和成年期都带来了重大挑战,在英国和美国,每1000例活产中就有多达10例受其影响。虽然新生儿筛查旨在早期发现DDH,但漏诊可能导致严重并发症,如成人髋关节发育不良和早发性骨关节炎。治疗选择范围从保髋手术等侵入性较小的手术到全髋关节置换术(THA)等更广泛的干预措施,这取决于病情的严重程度。术前规划对于优化接受THA的DDH患者的手术结果起着关键作用。这包括精确的成像方式、髋臼骨量的精确测量、股骨头半脱位的评估以及预测假体尺寸和腿长差异。人工智能和机器学习的最新进展提供了有前景的工具来提高术前规划的准确性。然而,在验证这些技术并将其整合到临床实践中仍存在挑战。这篇社论强调了持续研究的重要性,通过循证方法和技术创新来完善术前策略并改善DDH管理的结果。

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