Modified Shelf Acetabuloplasty Endoscopic Procedure With Allograft for Developmental Hip Dysplasia Treatment.
Modified Shelf Acetabuloplasty Endoscopic Procedure With Allograft for Developmental Hip Dysplasia Treatment.
复制标题
DOI：
10.1016/j.eats.2018.03.015
复制
发表时间：
2018-07
影响因子：
1.2
通讯作者：
Domb BG
中科院分区：
文献类型：
--
作者：
Maldonado DR;Ortiz-Declet V;Chen AW;Lall AC;Mohr MR;Laseter JR;Domb BG
髋关节发育不良已被确定为骨关节炎的主要原因之一。然而，在髋关节发育不良的情况下，单独使用髋关节镜仍然存在争议。在边缘性髋关节发育不良中，外侧中心边缘角（LCEA）在18°和25°之间，报告了适当的关节囊和盂唇处理的良好结局。然而，在LCEA低于18°的严重髋关节发育不良中，必须解决髋臼骨结构缺陷。即使髋关节镜在解决与不稳定相关的关节内损伤方面具有潜在受益，但它不能用于软组织手术。髋臼周围截骨术仍然是解决这一问题的金标准;然而，其侵入性沿着长恢复时间使得一些患者不愿意接受该手术。新的微创内窥镜手术，来自开放技术，描述髋臼自体骨移植作为一种替代方法。当使用自体移植物时，供体侧发病率一直是一个问题;我们相信使用同种异体骨将减少这一潜在问题，并使手术本身的侵入性更小。本技术说明将描述一种使用同种异体髂骨移植物的内窥镜髋臼成形术。
Hip dysplasia has been identified as one of the leading causes of osteoarthritis. However, hip arthroscopy alone, in the setting of hip dysplasia, remains controversial. In borderline hip dysplasia, with lateral center-edge angle (LCEA) between 18° and 25°, good outcomes have been reported with appropriate capsular and labral management. However, in severe hip dysplasia, with LCEA below 18°, there is an acetabular bony structural deficiency that must be addressed. Even with the potential benefit of hip arthroscopy in addressing intra-articular injuries related to the instability, it cannot be used for soft-tissue procedures. Periacetabular osteotomy remains the gold standard to address that matter; however, its invasive nature along with the long recovery time leaves some patients unwilling to undergo this procedure. New minimally invasive endoscopic procedures, derived from open techniques, describe acetabular autologous bone grafting as an alternative. Donor-side morbidity is always a concern when using autografts; we believe that the use of bone allograft will decrease this potential issue and make the procedure itself less invasive. This Technical Note will describe a type of endoscopic shelf acetabuloplasty using an allograft iliac bone graft.