髋臼周围截骨术联合髋关节镜治疗髋关节发育不良的回顾性研究  

A retrospective study of periacetabular osteotomy combined with hip arthroscopy in the treatment of developmental dysplasia of the hip

作　　者：彭建平[1] 李扬 肖飞[1] 朱俊峰[1] 沈超[1] 陈晓东[1] Peng Jianping;Li Yang;Xiao Fei;Zhu Junfeng;Shen Chao;Chen Xiaodong(Department of Orthopedics,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200092,China)

机构地区：[1]上海交通大学医学院附属新华医院骨科,上海200092

出　　处：《生物骨科材料与临床研究》2023年第4期9-13,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨髋臼周围截骨术(periacetabular osteotomy,PAO)手术同期进行关节镜下盂唇修补术的可行性和早期临床效果。方法研究对象为2020年1月至2021年12月期间上海交通大学医学院附属新华医院因确诊发育性髋关节发育不良(developmental dysplasia of the hip,DDH)行髋关节镜下盂唇修补和PAO术的患者。共纳入157例,男17例,女140例;左髋60例,右髋97例;平均年龄(26.86±7.25)岁。术前及末次复查骨盆平片测量外侧中心边缘角(lateral center-edge angle,LCEA),髋臼指数(acetabulum index,AI),前壁指数(anterior wall index,AWI),后壁指数(posterior wall index,PWI),挤出指数(extrusion index,EI)。术前评估及术后末次复查分别进行i-HOT33评分,改良Harris髋关节功能评分(modified Harris hip score,mHHS)记录并发症。结果平均随访(16.99±3.41)个月。盂唇损伤于9:00,10:00,11:00,12:00,1:00,2:00,3:00分别为2例(1.27%),12例(9.45%),80例(51%),135例(86%),152例(96.82%),145例(92.36%)和1例(0.63%)。2例伤口愈合不良,3例会阴部水肿,27例术后股外侧皮神经支配区麻痹,无其他严重并发症。LCEA、AI、AWI、PWI、EI、i-HOT33、mHHS评分术后末次随访较术前均得到明显改善。结论PAO手术同期进行关节镜下盂唇修补可以改善短期内关节功能,并未额外增加手术风险。Objective To investigate the feasibility and early clinical effect of periacetabular osteotomy combined with arthroscopic labrum repair in the treatment of adolescent and adult developmental dysplasia of the hip.Methods A retrospective analysis was performed of patients diagnosed with DDH from January 2020 to December 2021 who underwent arthroscopic labrum repair and periacetabular osteotomy.A total of 157 cases were included,including 17 males and 140 females.There were 60 cases of the left hip and 97 cases of the right hip.The mean age was(26.86±7.25)years.The following parameters were measured by standing pelvic radiographs before operation and at the final review:Lateral center-edge angle(LCEA),acetabular index(AI),anterior wall index(AWI),posterior wall index(PWI),extrusion index(EI).Complications were also recorded.Results The mean follow-up was(16.99±3.41)months.There were 2 cases(1.27%),12 cases(9.45%),80 cases(51%),135 cases(86%),152 cases(96.82%),145 cases(92.36%),1 case(0.63%)of labrum injury at 9:00,10:00,11:00,12:00,1:00,2:00,and 3:00,respectively.There were 2 cases of delayed incision healing,3 cases of perineal edema,and 27 cases of paralysis of the lateral femoral cutaneous nerve innervation area.No other serious complications were found.LCEA,AI,AWI,PWI,EI,i-HOT33,mHHS scores were significantly improved at the last follow-up after surgery.Conclusion PAO surgery combined with arthroscopic labrum repair can improve joint function in the short term without additional complications.

关 键 词：发育性髋关节发育不良 盂唇 髋臼周围截骨术 髋关节镜 

分 类 号：R687.4[医药卫生—骨科学]