Trousdale R T, Ekkernkamp A, Ganz R, Wallrichs S L
University of Bern, Switzerland.
J Bone Joint Surg Am. 1995 Jan;77(1):73-85. doi: 10.2106/00004623-199501000-00010.
The results of periacetabular osteotomy, with and without intertrochanteric osteotomy, performed between January 1984 and December 1990, were reviewed for forty-two patients who had osteoarthrosis in a congenitally dysplastic hip. There were eight male and thirty-four female patients. The average age of the patients at the time of the operation was thirty-seven years (range, eleven to fifty-six years). Ten patients had combined periacetabular and intertrochanteric osteotomies. The preoperative severity of the osteoarthrosis, according to the criteria of Tönnis, was grade 1 in fifteen patients, grade 2 in eighteen, and grade 3 in nine. The average duration of follow-up was four years (range, two to eight years). Complications included heterotopic ossification in fourteen patients (33 per cent), non-union of the pubic osteotomy in two patients (5 per cent), and pain related to the hardware that led to its removal in nine patients (21 per cent). There were no major neurovascular complications. One patient had dysesthesias in the area supplied by the lateral femoral cutaneous nerve. Six patients had a subsequent total hip arthroplasty and three patients had an additional intertrochanteric osteotomy. five of the nine patients who had a second major operation had had grade-3 osteoarthrosis before the periacetabular osteotomy. The Harris hip score improved from an average of 62 points (range, 33 to 95 points) preoperatively to an average of 86 points (range, 29 to 100 points) postoperatively (p < 0.0001, paired t test). The result was excellent or good for thirty-two of the thirty-three patients who had had grade-1 or 2 osteoarthrosis. Eight of the nine patients who had had grade-3 osteoarthrosis had a Harris hip score of less than 70 points at the latest follow-up evaluation.
对1984年1月至1990年12月间行髋臼周围截骨术（伴或不伴转子间截骨术）的42例先天性髋关节发育不良性骨关节炎患者的结果进行了回顾。其中男性8例，女性34例。患者手术时的平均年龄为37岁（范围为11至56岁）。10例患者接受了髋臼周围截骨术联合转子间截骨术。根据Tönnis标准，术前骨关节炎的严重程度为：15例患者为1级，18例为2级，9例为3级。平均随访时间为4年（范围为2至8年）。并发症包括14例患者（33%）出现异位骨化，2例患者（5%）耻骨截骨不愈合，9例患者（21%）因与内固定相关的疼痛而取出内固定。无重大神经血管并发症。1例患者股外侧皮神经支配区域出现感觉异常。6例患者随后接受了全髋关节置换术，3例患者额外接受了转子间截骨术。9例接受二次大手术的患者中，有5例在髋臼周围截骨术前患有3级骨关节炎。Harris髋关节评分从术前平均62分（范围为33至95分）提高到术后平均86分（范围为29至100分）（配对t检验，p<0.0001）。33例患有1级或2级骨关节炎的患者中，32例的结果为优或良。9例患有3级骨关节炎的患者中，8例在最近一次随访评估时Harris髋关节评分低于70分。
