Barbaric Starcevic Katarina, Bicanic Goran, Bicanic Luka
Department of Orthopedic Surgery, Special Hospital for Orthopedics and Traumatology "Akromion", Zagreb 10020, Grad, Croatia.
Department for Orthopedic Surgery, Emirates Hospital Jumeirah Dubai, Dubai 00000, Dubayy, United Arab Emirates.
World J Orthop. 2024 Dec 18;15(12):1118-1123. doi: 10.5312/wjo.v15.i12.1118.
Hip arthroplasty in patients with a history of paediatric hip disorders presents a significant challenge for orthopaedic surgeons. These patients are typically younger and have greater functional demands. Therefore, achieving optimal biomechanical conditions is crucial, involving placement of the acetabulum at the ideal centre of rotation and securing a stable femoral component with good offset to preserve abductor muscle function and restore leg length. The altered anatomy in these cases makes total hip arthroplasty more complex, necessitating thorough preoperative imaging and an individualised surgical approach. Various techniques may be employed to optimise biomechanical outcomes. We propose a modified lateral hip approach, offering exceptional visualisation of the acetabulum and femur while preserving the continuity of the abductor muscles without requiring trochanteric osteotomy. To achieve the most biomechanically advantageous acetabular position, cotyloplasty is our preferred method.
有小儿髋关节疾病病史的患者进行髋关节置换术,对骨科医生来说是一项重大挑战。这些患者通常较为年轻,功能需求更高。因此,实现最佳生物力学条件至关重要,这涉及将髋臼放置在理想的旋转中心,并固定具有良好偏移的稳定股骨组件,以保留外展肌功能并恢复腿长。这些病例中改变的解剖结构使全髋关节置换术更加复杂,需要进行全面的术前影像学检查和个体化的手术方法。可以采用各种技术来优化生物力学结果。我们提出一种改良的髋关节外侧入路,在保留外展肌连续性且无需转子截骨的情况下,能提供髋臼和股骨的极佳视野。为达到生物力学上最有利的髋臼位置,髋臼成形术是我们的首选方法。