PAO截骨术治疗成人髋臼发育不良的临床研究  

A clinical study of periacetabular osteotomy in the treatment of adult developmental dysplasia of hip

作　　者：梅玉峰 郭海涛[1] 王波[1] 梁虎 蒋勇[1] 李辉[1] 刘曙光[1] 王宏涛[1] 吴奇[1] 李军[1] Mei Yufeng;Guo Haitao;Wand Bo(Rheumatism Immune Joint Orthopedics,Arthropathy Hospital,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学附属红会医院关节病医院风湿免疫关节矫形科,710054

出　　处：《美中国际创伤杂志》2021年第4期10-14,F0003,共6页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨应用PAO截骨手术治疗残留成人发育性髋臼发育不良的短中期疗效。方法:回顾性研究PAO截骨手术后的32例41髋的成人发育性髋臼发育不良手术疗效。女28例37髋,男4例4髋;年龄13-41岁,平均22.5岁。随访16-44个月,平均28个月。所有病例进行临床术后6w、12w、3月、6月、12月、24月、36月、48月影像学、关节炎改变TONNIS分型及髋关节功能Harris评分登记。随访资料进行术前及最后复查资料的对照研究,统计学分析术前、术后最后评分分组分析。结果:髋关节疼痛症状缓解率85%:髋关节功能(Harris)评分由术前平均77.4分(54.6-82.4分)提高至末次随访94.6分(67.7-98.2分);89%髋关节Harris评分提高10分以上,75%髋关节Harris评分超过80分。关节炎进展稳定率78%,关节炎Tonnis分型轻度关节炎进展9例,中度进展2例;平均术后3个月均获骨性愈合。并发症:术中髋臼骨折1例,术后截骨延迟愈合1例,皮肤浅表感染3例。3例术后仍有行走不适引发的跛行步态。结论:PAO截骨治疗成人残留髋白发育不良在解除疼痛症状、缓解髋关节炎进展有满意的中期疗效。Objective:To explore the short-term and mid-term effects of periacetabular osteotomy(PAO)in the treatment of residual adult developmental dysplasia of hip(DDH).Methods:The surgical effects of 32 cases(41 hips)of adult developmental acetabular dysplasia after PAO were studied retrospectively.Among them,including 28 female with 37 hips and 4 male with 4 hips,aging from 13 to 41 years,with an average age of 22.5 years.The imaging data,Tonnis classification and Harris score of hip joint function at 6w,12w,3 months,6 months,12 months,24 months,36 months,48 months after operation,were obtained and recorded in all cases.All cases were followed-up for 16-44 months,with an average duration of 28 months,the preoperative and postoperative follow-up data were compared and statistically analyzed.Results:The pain relief rate of the hip joint is 85%.Hip joint function(Harris)score increased from an average of 77.4 points(54.6-82.4 points)before surgery to 94.6 points(67.7-98.2 points)at the last follow-up.89% of the hip joint Harris scores improved by more than 10 points,and 75%of the Harris scores exceeded 80 points.Arthritis progression rate was 78%,mild arthritis progression in 9 cases and moderate progression in 2 cases based upon arthritis Tonnis classification.Bone union was obtained in an average of 3 months after operation.Complications included 1 case of intraoperative acetabular fracture,1 case of postoperative osteotomy delayed union,and 3 cases of superficial skin infection.3 cases of limp gait caused by walking discomfort after operation.Conclusion:PAO in the treatment of adult residual acetabular dysplasia has a satisfactory mid-term effect in relieving pain symptoms and relieving the progression of hip arthritis.

关 键 词：PAO截骨 髋关节 发育不良 

分 类 号：R68[医药卫生—骨科学]