髋臼旋转截骨术治疗早中期髋关节发育不良

目的探讨髋臼旋转截骨术治疗早中期髋关节发育不良的手术技术要点及中期疗效。方法2000年5月至2006年5月对12例（14髋）早、中期髋关节发育不良患者进行了髋臼旋转截骨术，所有患者均为女性，手术时年龄13—46岁，平均28．9岁。随访时间3．1—9．1年，平均6．0年。术前、术后及随访时X线片上测量CE角，髋臼顶角及头外移指数。Harris评分判断髋关节功能。手术采用Oilier外侧“U”形入路，股骨大转子截骨显露。术后未行外固定。结果患者疼痛症状得到明显改善，Harris评分术前72分，术后91分（P〈0．001）。CE角术前0．9°，术后27°（P〈0．001）；髋臼顶角术前为29°，术后5°；头外移指数术前为0．68，术后0．65。所有病例截骨块及股骨大转子截骨处愈合良好。结论Oilier外侧“U”形入路行髋臼旋转截骨术髋臼缘显露充分；治疗早中期髋关节发育不良可以缓解疼痛，延缓骨关节炎的进展速度，中期随访疗效满意。

Rotational acetabular osteotomy for early-mid-stage osteoarthritis secondary to acetabular dysplasia

Objective To explore the surgical technique and therapeutic effects of rotational acetabular osteotomy for early-mid-stage osteoarthritis secondary to acetabular dysplasia. Methods Rotational acetabular osteotomy in 14 hips of 12 patients were performed from May 2000 to May 2006. All patients were female and the average age was 28.9 years （ 13 to 46 years） at surgical time. The mean duration of clinical and roentgenographic follow-up was 6. 0 years （3.1 to 9. 1 years）. The center-edge angle, acetabular roof angle, head lateralization index were measured on radiographs made preoperatively, postoperatively, and at the time of final follow-up. Clinical follow-up was performed with the Harris hip score. The acetabular osteotomy was performed through an Ollier lateral U transtroehanterie approach and no postoperative traction or cast immobilization was used. Results All patients had satisfactory relief from pain. The mean preoperative Harris score was 72 points, which improved to a mean of 91 points at the time of the last follow-up （P 〈 0. 001 ）. The mean center-edge angle improved from 0. 9° to 27° （P 〈0. 001 ） , the mean acetabular roof angle changed from 29° to 5° （P 〈0. 001 ）, the mean head lateralization index improved from 0. 68 to 0. 65. Solid bone-to-bone healing of the osteotomy site and the great troehanter was observed in any patient. Conclusion Rotational aeetabular osteotomy through an Ollier lateral ＂U＂ type approach provides wide exposure for surgery, and for early-stage osteoarthritis secondary to acetabular dysplasia it can relieve pain and reduce the severity of osteoarthritis. A satisfactory therapeutic effect can be obtained.