CAJ | 학술논문

目的评价软组织平衡技术在全髋关节置换术治疗成人高位髋关节发育不良的效果.方法 2000年12月至2006年8月应用全髋关节置换术治疗21例(26髋)高位髋关节发育不良患者(CreweⅢ型20髋;Ⅳ型6髋).通过软组织松解及股骨转子下短缩截骨重建髋臼于真臼水平,评价其术后临床及影像学结果.术前Harris评分平均41.2分.结果 21例患者获得13个月～7年随访,平均随访时间4.8年.16例患者术后跛行程度明显改善;通过软组织松解可显著纠正下肢不等长,有效减少手术截骨长度.术后Harris评分平均89.6分.患者术后未见脱位、感染及假体松动.结论适当的软组织松解和平衡可使高位髋臼重建于真臼,有效地恢复髋关节的形态和功能,获得满意的近期效果.
목적 평개연조직평형기술재전관관절치환술치료성인고위관관절발육불량적효과.방법 2000년12월지2006년8월응용전관관절치환술치료21례(26관)고위관관절발육불량환자(CreweⅢ형20관;Ⅳ형6관).통과연조직송해급고골전자하단축절골중건관구우진구수평,평개기술후림상급영상학결과.술전Harris평분평균41.2분.결과 21례환자획득13개월～7년수방,평균수방시간4.8년.16례환자술후파행정도명현개선;통과연조직송해가현저규정하지불등장,유효감소수술절골장도.술후Harris평분평균89.6분.환자술후미견탈위、감염급가체송동.결론 괄당적연조직송해화평형가사고위관구중건우진구,유효지회복관관절적형태화공능,획득만의적근기효과.
Objective To assess clinical reanh of soft tissue balancing in primary total hip arthroplasty for severe developmental dysplasia of the hip in adults.Methods From December 2000 to August 2006, 26 primary cementless total hip arthroplasties combined with soft tissue balancing were performed in 21 cases for the treatment of severe developmental dysplasia of the hip.Patients were classified as type Ⅲ(20 hips) and type Ⅳ(6 hips) according to Crowe classification.All acetabular cups were placed in their original anatomic location by soft tissue releasing and subtrochanteric shortening osteotomy.Thereafter, postoperative clinical and radiological results were evaluated.Results The mean length of follow-up was 4.8 yeats (range, 13 months-7 years).Limp improved by at least one grade in 62% of the cases.Leg-length discrepancy was corrected significantly and osteotomy was undertaken in 13 hips with a mean decrease length of 0.9 cm by effective releasing.Harris scores improved significantly from a mean of 41.2 preoperatively to 89.6 postoperatively.No dislocations, infections and prosthesis loosening were found at the final follow-up evaluation.Conclusion Soft tissue balancing in total hip arthropalsty can facilitate acetabular reconstruction to normalize the hip center in severe developmental dysplasia of the hip, as a result, satisfactory short-term resttlt can be obtained by restoring normal function and anatomic structure.