Effect of pelvic osteotomy in the skeletally immature on acetabular coverage.
Effect of pelvic osteotomy in the skeletally immature on acetabular coverage.
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DOI：
10.1007/s11420-012-9286-8
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发表时间：
2012-10-01
期刊：
影响因子：
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通讯作者：
Beaule, Paul E
中科院分区：
文献类型：
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作者：
Al-Moussa, Sulaiman;Moroz, Paul;Beaule, Paul E
背景：尽管儿童骨盆截骨术对于重建髋关节有效，但其对髋关节发育（髋臼覆盖）的影响尚不清楚。目的：本研究的目的是确定儿童时期接受骨盆截骨术的患者髋臼过度覆盖的患病率及其对患者功能的影响。患者和方法：1980 年至 2008 年间，所有接受骨盆截骨术的患者对我们机构针对非神经性髋关节发育不良 (DDH) 或继发于骨骼成熟之前的 Legg-Calve-Perthes 病 (LCP) 进行的截骨术进行了回顾。完成了临床评估和 WOMAC、UCLA 活动评分、Marx 活动评分和 SF-36 生活质量问卷。进行标准化的 AP 骨盆 X 射线检查，以确定髋臼覆盖范围、后倾体征和退行性改变。 结果：确定了 28 名患者（32 髋），其中 14 名（9 名 DDH，5 名 LCP）同意参与。八名患者的撞击征呈阳性（六名 DDH，两名 LCP）。交叉和坐骨棘征分别出现在十个臀部。 Tonnis 等级为：1 髋中为 0、10 髋中为 1、2 髋中为 2、1 髋中为 3。平均托尼斯角为 11.6±8.6°。平均CE角为24.0±15.9°，其中六个髋部的CE角为40°。交叉征或坐骨征与Tonnis分级（p=0.739）、髋部疼痛（p=0.520）或撞击征（p=1.00）之间没有相关性。结论：髋臼过度覆盖在儿童时期接受骨盆截骨术的患者中很常见。在我们的患者队列中，没有发现后倾和髋部疼痛之间存在相关性。
BACKGROUND: Although pelvic osteotomy in children has been effective in re-establishing containment of the hip joint, its impact on hip joint development with respect to acetabular coverage is ill defined.PURPOSE: The purpose of this study is to determine the prevalence of acetabular overcoverage in patients who had pelvic osteotomy during childhood and its impact on patient function.PATIENTS AND METHODS: Between 1980 and 2008, all patients who had a pelvic osteotomy done at our institution for non-neuropathic hip dysplasia (DDH) or secondary to Legg-Calve-Perthes disease (LCP) prior to skeletal maturity were reviewed. A clinical assessment and the WOMAC, UCLA Activity Score, Marx activity score, and SF-36 quality-of-life questionnaires were completed. A standardized AP pelvic X-ray was performed to determine the acetabular coverage, signs of retroversion, and degenerative changes.RESULTS: Twenty-eight patients (32 hips) were identified, of which 14 (9 DDH, 5 LCP) agreed to participate. Impingement sign was positive in eight patients (six DDH, two LCP). Crossover and ischial spine signs were each present in ten hips. Tonnis grades were: 0 in 1 hip, 1 in 10 hips, 2 in 2 hips, and 3 in 1 hip. The mean Tonnis angle was 11.6±8.6°. The mean CE angle was 24.0±15.9° with six hips having a CE angle 40°. There was no correlation between crossover sign or ischial sign and Tonnis grade (p=0.739), hip pain (p=0.520), or impingement sign (p=1.00).CONCLUSIONS: Acetabular overcoverage is common in patients who underwent pelvic osteotomy during childhood. No correlation was identified between retroversion and hip pain in our patient cohort.