Pitto R P, Klaue K, Ganz R
Orthopädische Klinik, Friedrich-Alexander-Universität, Erlangen-Nürnberg.
Z Orthop Ihre Grenzgeb. 1996 Sep-Oct;134(5):452-6. doi: 10.1055/s-2008-1037437.
Thirty-seven operatively treated patients with residual acetabular dysplasia without arthritis had a labrum tear in the antero-lateral quadrant. A sensation of hip locking, or of a "dead leg" and episodes of "giving-way" were found to predict the presence of the tear. 95% of patients had an acute onset of pain. We treated the patients with a peri-acetabular osteotomy and in 12 cases the tear was repaired with a transosseous suture. We excised the labrum lesion in 21 cases with an extended avulsion from the bony rim and 4 tears were not severe enough to require attention. Twenty-two patients were available for a 4.5-year follow-up (range 2-8 years): 18 patients had no pain, 3 had mild pain and one had severe pain. Final pain outcome was not influenced by intraarticular treatment of the tear. The labrum tear is responsible for a well-defined clinical presentation of hip dysplasia and precedes secondary arthrosis. Early diagnosis helps to define the time to perform reconstructive surgery. The treatment consists of improving the coverage and stability of the femoral head by means of a multiplanar peri-acetabular osteotomy. The osteotomy unloads the torn fibrocartilage and allows it to heal by moving it out of the weight-bearing area.
37例接受手术治疗的髋臼发育不良但无关节炎的患者，其髋臼唇在髋臼前外侧象限出现撕裂。发现髋关节绞锁感、“木腿”感及“打软腿”发作可预测撕裂的存在。95%的患者疼痛急性发作。我们对这些患者进行了髋臼周围截骨术，其中12例通过经骨缝合修复了撕裂。我们对21例伴有骨缘广泛撕脱的髋臼唇病变进行了切除，4例撕裂不严重无需处理。22例患者获得了4.5年的随访（范围2 - 8年）：18例患者无疼痛，3例有轻度疼痛，1例有重度疼痛。撕裂的关节内治疗对最终疼痛结局无影响。髋臼唇撕裂导致髋臼发育不良明确的临床表现，并先于继发性关节炎出现。早期诊断有助于确定进行重建手术的时机。治疗方法包括通过多平面髋臼周围截骨术改善股骨头的覆盖和稳定性。截骨术可减轻撕裂的纤维软骨的负荷，并通过将其移出负重区域使其愈合。
