成人髋关节发育不良治疗新进展

背景：成人髋关节发育不良最终将发展为髋关节骨关节炎产生严重功能障碍,其治疗方式的选择因患者年龄及临床症状而不同,一直是髋关节外科领域争论的焦点。 目的：就髋关节发育不良的病因、发病机制、诊断及治疗等最新研究进展作一综述。 方法：由第一作者应用计算机检索PubMed数据库及中国期刊网全文数据库2000-01/2011-12有关成人髋关节发育不良等方面的文章,英文检索词为“development dysplasia of the hip,total hip replacement,osteotomy”,中文检索词为“髋关节,发育不良,关节置换,截骨手术”。排除重复性研究,共保留30篇文献进行综述。 结果与结论：髋关节发育不良可能起始于胚胎期软骨原基阶段,因为软骨发育障碍或者软骨骨化障碍所致。目前临床对于成人髋关节发育不良的治疗方法较多,对于年轻的早、中期患者可采取各种类型的重建性骨盆截骨手术,以达到缓解疼痛及阻断或延缓继发性骨关节炎病理进程的目的;对于晚期病例目前主要以关节置换为主,重建患者的髋关节正常生理功能。

New progress in the treatment of adult hip dysplasia

BACKGROUND: Adult hip dysplasia is a common orthopedic disease; it will be developed for hip osteoarthritis severe dysfunction. The choice of treatment modality for patients is according to different age and clinical symptoms, which has been the focus of debate hip surgery. OBJECTIVE: To summarize the new research progress from the aspects of hip dysplasia etiology, pathogenesis, diagnosis and treatment.   METHODS: A computer-based retrieval was performed by the first author in the CNKI database and PubMed database to search papers on adult hip dysplasia published between January 2000 and December 2011 using key words of “development dysplasia of the hip, total hip replacement, osteotomy” in Chinese and English. According to inclusion and exclusion criteria, 30 papers were included in the final analysis. RESULTS AND CONCLUSION: Hip dysplasia may be starting in the cartilage primordium stage of the embryonic period, and caused by cartilage developmental disorders or ossification of cartilage disorders. There are many methods of the current clinical treatment for adult hip dysplasia, and for the young patients in the early and mid-term can take various types of reconstructive pelvic osteotomy surgery to alleviate pain and prevent or delay the process of secondary osteoarthritis pathology. And for the advanced patients, the treatment is mainly dependent on the joint replacement and reconstruction of the hip normal physiological function.