改良Smith Peterson入路髋臼周围截骨术治疗成人髋关节发育不良

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Objective To evaluate early and mid term effectiveness of periacetabular osteotomy(PAO)through modified Smith Peterson for development dysplasia of the hip (DDH)in adults.Methods 21 adults with DDH underwent PAO through modified SmithPeterson at Quanzhou Orthopaedics Hospital between April 2018 and January 2021.There were 1 male (1 hip) and 20 females (20 hips) containing 12 left hips and 9 right hips.The ages ranged from 18 to 44 years with a mean of (32.15±10.81)years.Among them，5 cases (5 hips) were categorized as modified T-nnis stage 0，14 cases (14 hips) as stage I，and 2 cases (2 hips) as stage Ⅱ.Intraoperative blood loss，surgical duration，hospitalization duration，occurrence of complications and preand post-operative Harris hip scores were recorded.Imaging assessments included lateral center edge(LCE) angle，acetabular inclination angle (T-nnis angle)，extrusion index (EI)，and anterior center edge (ACE) measured via X-rays.Results Bleeding volume was (779.52±29.60)mL，operation time was (115.95±4.44)min，the length of hospital stay was (7.29±0.35)days.Follow-up of all patients was (33.73±9.12)months (range 24~48 months).There were no complications such as vascular injury，fracture of posterior column of acetabulum，poor wound healing，infection，deep venous thrombosis of lower extremity.Postoperative numbness of the lateral femoral cutaneous nerve occurred in 2 adults(2 hips) and disappeard postoperatively 3 months without special treatment.At last follow up，Harris hip score was (89.67±3.44)，significantly better than preoperative ones (72.67±4.32)(P＜0.05).At 1 year after operation，X-ray films showed that the all osteotomies healed and there was no osteotomy block osteonecrosis.Postoperative LCE angle was (31.67±3.86)°，significantly better than preoperative ones (9.86±3.25)°(P＜0.05).Postoperative T-nnis angle was (6.57±2.44)°，significantly better than preoperative ones(15.05±2.48)°(P＜0.05).Postoperative EI was (11.33±2.96)%，which was significantly better than preoperative ones (29.19±2.89)% (P＜0.05).Postoperative ACE angle was (30.67±3.71)°，which was significantly better than preoperative ones (8.62±3.31)°(P＜0.05).Conclusion If the indications for surgery are strictly controlled and prevention and treatment of common surgical complications are payed attention to，PAO through modified Smith Peterson for DDH in adults can effectively improve the osseous covering of hip joint and significantly improve hip joint function，providing satisfactory early and mid-term clinical outcome.

Key words： modified Smith Peterson periacetabular osteotomy development dysplasia of the hip

Corresponding Authors: Wu Zhaoke

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	Ling Hanghui
	Xu Zhiqing
	Zhuang Zhikun
	Wu Zhaoke

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Ling Hanghui,Xu Zhiqing,Zhuang Zhikun, et al. Periacetabular Osteotomy Through Modified Smith Peterson for Development Dysplasia of the Hip in Adults[J]. sygkzz, 2023, 29(12): 1070-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I12/1070

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