伯尔尼髋臼周围截骨术治疗髋关节发育不良的近期疗效

摘要

目的 探讨经改良Smith-Peterson入路伯尔尼髋臼周围截骨术(PAO)治疗青少年及成人髋关节发育不良(DDH)的近期临床疗效.方法 采用PAO治疗20例DDH患者(20髋).其中3例联合股骨近端截骨及髋关节外科脱位,5例联合髋关节外科脱位.对比手术前后影像学指标及Harris评分.结果 患者均获得随访,时间12~33个月.术后外侧CE角、髋臼顶倾斜角均较术前明显改善,差异有统计学意义(P<0.05).15例疼痛消失,5例疼痛症状明显好转.末次随访时,患侧髋关节Harris评分由术前(76.75±13.09)分改善为(88.55±9.41)分,其中Harris疼痛评分由术前(30.50±7.59)分改善为(41.50±5.10)分,差异均有统计学意义(P<0.05).结论 采用改良Smith-Peterson入路PAO治疗DDH可以获得较好的早期疗效,可矫正股骨头覆盖,有望延缓骨关节炎进展.%Objective To investigate the short-term clinical effect of Bernese periacetabular osteotomy(PAO) for adolescents and adults with developmental dysplasia of the hip(DDH) via modified Smith-Peterson approach.Methods A total of 20 DDH patients (20 hips) had been treated with PAO,of which 3 cases combining with proximal femoral osteotomy and surgical hip dislocation,5 cases combining with surgical hip dislocation.The imaging parameters and Harris score were compared between preoperatively and postoperatively.Results All patients were followed up for 12~33 months.Postoperatively,the lateral center-edge angle,the horizontal tilt angle were improved significantly than preoperatively;the differences were statistically significant(P<0.05).At last follow-up,pain of 15 hips disappeared,pain of 5 hips significantly relieved.At the last follow-up,Harris hip score increased from (76.75±13.09) points preoperatively to (88.55±9.41) points,of which Harris hip pain score increased from (30.50±7.59) points preoperatively to (41.50±5.10) points,the differences were statistically significant(P<0.05).Conclusions PAO for the treatment of DDH via modified Smith-Peterson approach obtain impressive short-term effectiveness,which can correct femoral head coverage and prevent the progression of osteoarthritis hopefully.