Outcome of rotational acetabular osteotomy for early hip osteoarthritis secondary to dysplasia related to femoral head shape - 49 hips followed for 10-17 years
Outcome of rotational acetabular osteotomy for early hip osteoarthritis secondary to dysplasia related to femoral head shape - 49 hips followed for 10-17 years
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DOI：
10.1080/17453670710014699
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发表时间：
2008-01-01
影响因子：
3.7
通讯作者：
Shindo, Hiroyuki
中科院分区：
文献类型：
--
作者：
Okano, Kunihiko;Enomoto, Hiroshi;Shindo, Hiroyuki
背景日本患者的髋关节骨关节炎大多数是继发于先天性髋关节脱位或髋臼发育不良，通常与股骨头畸形有关。因此，我们检查了髋关节发育不良继发早期骨关节炎患者的髋臼旋转截骨术（RAO）手术的结果，以及其与股骨头畸形的关系。患者和方法我们回顾性审查了48名患者（43名女性）的49个髋关节的RAO手术结果。所有患者都有早期骨关节炎的影像学证据。手术时平均年龄为33（13-54）岁，平均随访时间为13（10-17）年。在术前X线片上测量股骨头圆度指数。采用Merle d 'Aubign和Postel系统进行临床随访。结果术前平均临床评分为13分，最近一次随访时已提高至17分（p 0.001）。从放射学角度来看，该手术充分改善了股骨头覆盖范围。随访时，38例髋关节的骨关节炎分期无变化，11例髋关节进展。11例骨关节炎阶段进展的髋关节中有2例出现明显的技术失败，并从后续比较中排除。38例无明显进展的髋关节与9例进展的髋关节的股骨头平均术前圆形指数不同（分别为55%和68%; p <0.001）。解释股骨头变形的患者在RAO手术后10年内可能会发生骨关节炎进展，即使是早期骨关节炎。
Background Hip osteoarthritis in Japanese patients is in most cases secondary and purpose to congenital dislocation of the hip or acetabular dysplasia - often associated with a deformed femoral head. Thus, we examined the outcome of rotational acetabular osteotomy (RAO) procedures in patients with early-stage osteoarthritis secondary to developmental dysplasia of the hip, and its relationship to femoral head deformity.Patients and methods We retrospectively reviewed the outcome of RAO procedures in 49 hips of 48 patients (43 females). All patients had radiographic evidence of early-stage osteoarthritis. The mean age was 33 (13-54) years at surgery, and the mean duration of follow-up was 13 (10-17) years. The roundness index of the femoral head was measured on preoperative radiographs. Clinical follow-up was performed using the Merle d'Aubign and Postel system.Results The mean preoperative clinical score was 13 points; this had improved to 17 points at the most recent follow-up (p 0.001). Radiographically, this procedure gave adequate improvement of femoral head coverage. At follow-up, stage of osteoarthritis was unchanged in 38 hips and had progressed in 11 hips. 2 of the 11 hips with progression of the osteoarthritic stage had obvious technical failure and were excluded from subsequent comparisons. The mean preoperative round index of the femoral head was different for the 38 hips with no obvious progression than for the 9 hips that showed progression (55% and 68%, respectively; p 0.001).Interpretation Patients with a deformed femoral head may experience progression of osteoarthritis within 10 years of the RAO procedure, even in early-stage osteoarthritis.