Long-Term Results of Cementless Total Hip Arthroplasty With Subtrochanteric Shortening Osteotomy in Crowe Type IV Developmental Dysplasia
Long-Term Results of Cementless Total Hip Arthroplasty With Subtrochanteric Shortening Osteotomy in Crowe Type IV Developmental Dysplasia
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DOI：
10.1016/j.arth.2016.11.005
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发表时间：
2017-04-01
影响因子：
3.5
通讯作者：
Zhou, Zong-Ke
中科院分区：
文献类型：
--
作者：
Wang, Duan;Li, Ling-Li;Zhou, Zong-Ke
背景资料：当外科医生在全髋关节置换术（THA）中重建与严重髋关节发育不良（DDH）相关的高度脱位髋关节时，存档长期稳定的植入物固定并改善患者功能和满意度仍然具有挑战性。本研究的目的是评价Crowe IV型-Hartofilakalloy III型DDH患者行非骨水泥组配式THA的转子下横向短截骨术的10年结局。方法：我们回顾了2002 - 2010年期间接受非骨水泥THA联合转子下横向短截骨术的62例患者（76髋）。共有49名女性和13名男性，平均年龄为38.8岁，所有人都患有Crowe IV型DDH。平均随访时间为10年。结果：术后髋关节Harris评分由术前平均38.8分提高到86.1分，差异有统计学意义（P < 0.05）。同样，改良Merle d'Aubigne和Postel髋关节评分、髋关节功能障碍和骨关节炎结局评分以及SF-12也显著改善。平均肢体长度差异从4.3 cm减少到1.0 cm。平均随访10年，术后脱位3例，暂时性神经麻痹2例，骨不连1例，术中骨折4例。结论：非骨水泥组配式全髋关节置换联合股骨粗隆下横向截骨术是一种有效、可靠的技术，内固定成功率高，临床效果满意。(C)2016 Elsevier Inc. All rights reserved.
Background: When surgeons reconstruct hips with a high dislocation related to severe developmental dysplasia of the hip (DDH) in total hip arthroplasty (THA), archiving long-term stable implant fixation and improving patient function and satisfaction remain challenging. The purpose of this study was to evaluate the 10-year outcomes of transverse subtrochanteric shortening osteotomy in cementless, modular THA in Crowe type IV-Hartofilakidis type III DDH.Methods: We reviewed 62 patients ( 76 hips) who underwent cementless THA with transverse subtrochanteric shortening osteotomy from 2002-2010. There were 49 women and 13 men with a mean age of 38.8 years, all of whom had Crowe type IV DDH. Mean follow-up period was 10 years. The acetabular cup was implanted in placement of the anatomical hip center in all hips.Results: The mean Harris Hip Score significantly improved from 38.8 points to 86.1 points. Similarly, modified Merle d'Aubigne and Postel Hip Score, Hip dysfunction and Osteoarthritis Outcome Score, and SF-12 also significantly improved. The mean limb length discrepancy was reduced from 4.3 cm to 1.0 cm. At mean follow-up of 10 years, there were 3 cases of postoperative dislocation, 2 cases of transient nerve palsy, 1 case of nonunion, and 4 cases of intraoperative fracture. Revision surgery was performed in 2 patients due to isolated loosening of acetabular component and femoral stem, respectively.Conclusion: Our data demonstrated that the cementless, modular THA combined with transverse subtrochanteric shortening osteotomy was an effective and reliable technique with high rates of successful fixation of the implants and satisfactory clinical outcomes. (C) 2016 Elsevier Inc. All rights reserved.