Ferguson G M, Cabanela M E, Ilstrup D M
Department of Orthopedics, Mayo Clinic, Mayo Medical School, Rochester, Minnesota 55905.
J Bone Joint Surg Br. 1994 Mar;76(2):252-7.
From 1969 through 1982, 305 hips in 290 patients had total hip arthroplasty for failed femoral intertrochanteric osteotomy. Of these, we reviewed 215 hips (70.5%) with a minimum follow-up of five years. The results were good or excellent in 79%, but there were technical problems at operation in 23% and a total perioperative complication rate of 11.8%. Late complications occurred in 13.1% including seven late infections (3.2%). At a mean follow-up of ten years, 39 hips had been revised (18.1%), there was probable loosening in 19.5% of stems and 12.6% of cups and possible loosening in 11.4% of stems and 7.2% of cups. The cumulative probability of failure at ten years was 20.6%. We recommend that intertrochanteric osteotomy be advised, planned and executed bearing in mind the possible need for a subsequent total hip arthroplasty, and that screws and plates should be routinely removed soon after union of the osteotomy.
1969年至1982年期间，290例患者的305髋因股骨转子间截骨术失败而接受了全髋关节置换术。其中，我们对215髋（70.5%）进行了回顾，这些患者的最短随访时间为5年。结果显示，79%的患者结果为良好或优秀，但23%的患者在手术中存在技术问题，围手术期总并发症发生率为11.8%。13.1%的患者出现晚期并发症，其中包括7例晚期感染（3.2%）。在平均10年的随访中，39髋（18.1%）进行了翻修，19.5%的股骨柄和12.6%的髋臼杯可能出现松动，11.4%的股骨柄和7.2%的髋臼杯可能存在松动。10年时的累积失败概率为20.6%。我们建议，在建议、计划和实施转子间截骨术时，应考虑到后续可能需要进行全髋关节置换术，并且在截骨术愈合后应尽快常规取出螺钉和钢板。
