髋臼周围截骨术治疗成人髋关节发育不良解析.ppt

This is another severe subluxed left hip. After operation, this patient received very good hip coverage. She is happy with her new hip. We started PAO in 1997, up to now we have finished more than 400 cases with very satisfied mid-term follow-up results. We have published our 4-10 years follow-up results which showed 93% good and excellent results. This is 28 years old lady with bilateral hip dysplasia. She had received bilateral PAO with excellent results. The interval bilateral operations will take about 6 to 12 months. * * * * 手术中如何评价髋臼旋转是否满意截骨术后髋臼前倾 从1997年开始 目前已完成 600余例手术 中期随访结果良好 4-10 年随访结果: 93% 优良 (92ps, 104hips) Y. Huang, H. Zhang et al: Mid-term Follow-up of Bernese Periacetabular Osteotomy through Ilioinguinal Approach. Chin. J. Orthop. 27(7): 499-504, 2007 髋关节周围截骨术 长期随访结果 自2001年7月至2009年8月，共完成400余例 117人/124髋。男性22髋，女性102髋 年龄14—45岁，平均26.45岁。 随访时间20—121个月，平均49.2个月。 术前Harris评分85.04分，术后平均97.56分（P0.05） ； 术前Charlney评分15.6分，术后平均17.34分（P0.05）。 无不适，评分100分61髋（49.2%）， 髋膝酸胀疼痛，54髋（43.5%）， 弹响，37髋（29.8%）， 交锁，3髋， 麻木僵硬或无力11髋（8.9%）， 跛行、肩歪、伤口分泌物各1髋。 中重度髋臼发育不良（CE0°）中期随访疗效满意率更高。 臼顶负重区平分线偏移角（±10°）能够较好预测中远期临床疗效。 患者自我评价 手术非常值得 108髋（87.10%）， 部分解决问题6髋（4.84%）， 手术前后无明显区别3髋（2.42%）， 手术后不如术前1髋（0.81%）。 另有6髋（4.84%）表示暂时不能评价手术效果，需要进一步观察。 Mean 20-year Followup The Kaplan-Meier survival analysis is shown with the conversion to a THA or hip fusion as the end points. 63 patients (75 hips); 4 patients (five hips) lost; and 1 patient (two hips) died. Age: 29 years (range, 13–56 years); mean, 20.4 years( range, 19–23 years); 41 hips (60%) preserved at last followup. -----------Simon D. Steppacher, Moritz Tannast , Reinhold Ganz , Klaus A. Siebenrock. Clin Orthop Relat Res (2008) 466:1633–1644 Fig. 3A–G Radiographs are shown of a 26-year-old woman with a dysplastic right hip with (A) an LCE angle of 16 and an AI of 12 without any signs of osteoarthritis. (B) The postoperative LCE angle was 32 and the AI -2. At the (C) 10- year and the (D) 20-year followups, no osteoarthitic