大转子滑移截骨在人工全髋关节置换术治疗强直髋时的应用

目的:探讨大转子滑移截骨技术在人工全髋关节置换术治疗强直髋时的作用,以及其可能出现的并发症。方法:回顾性总结2010年4月至2014年12月治疗的强直髋12例,男9例,女3例;平均年龄49.9岁(37~62岁)。临床效果评估采用Harris评分,影像学评估包括大转子截骨愈合情况、假体松动情况和异位骨化情况。结果 :随访时间15~22个月,平均17.3个月。Harris评分术前43.96±8.46,术后88.00±6.11,术后评分明显改善(t=-18.34,P=0.00)。所有大转子截骨均骨性愈合,未见假体松动、异位骨化、假体脱位发生。术后感染1例,大转子区域疼痛1例。结论:大转子滑移截骨技术在人工全髋关节置换术治疗强直髋时是一种有效的增加手术暴露的方式,未发现严重的截骨相关性并发症,截骨愈合率可靠。

Application of greater trochanteric slide osteotomy in total hip arthroplasty for stiff hip

Objective: To study the effect of greater trochanteric slide osteotomy(GTSO) in total hip arthroplasty (THA) for the treatment of stiff hip,as well as the potential complications.Methods: There were 12 cases enrolled in the study from April 2010 to December 2014,including 9 males and 3 females. The mean age was 49.9 years old (ranged,37 to 62 years old). The clinical result was evaluated according to the Harris evaluation system,and the radiological evaluations included the healing of the osteotomy,the stability of the prosthesis,and occurrence of heterotopic ossification (HA).Results: The mean follow-up period was 17.3 months (ranged,15 to 22 months). The mean postoperative Harris score was 88.00±6.11,which was significantly higher than the preoperative mean score which was 43.96±8.46(t=-18.34,P=0.00). All the osteotomy site abtained good healing without prosthesis loosening or HA. There was 1 patient with infection and 1 patient with pain in greater trochanter.Conclusion: GTSO is an effective exposure technique in THA for stiff hip,and no marked complication associated with the osteotomy is found in the study.