髋关节外科脱位入路治疗塌陷前期股骨头坏死

Abstract
Figure/Table
References (0)
Related Citation (11)

Download: PDF (1627 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To discuss the short-term clinical efficacy of surgical hip dislocation approach in the treatment of pre-collapse stage of femoral head necrosis. Methods A retrospectively analysis was made on the clinical data of 43 patients(43 hips) with femoral head necrosis treated through surgical hip dislocation approach from January 2014 to December 2016，including 28 males and 15 females with an average of 36.8 years.All cases were examined with radiography，If necessary，CT or MRI examination would be used to observe the necrosis of the femoral head changes and whether there was collapse 1，3，6，and 12 months after operation and The function was evaluated with the preoperative and postoperative Harris score.Results One-stage healing of incision was obtained in all patients after surgery without complications of infectious and lower limbs deep venous thrombosis.During follow-up，there were no non-unions of the trochanteric osteotomy sites，no signs of AVN or inter-trochanteric fractures.The mean follow-up time was 21.8 months(range，14~36 months).All patients had some degree of the pain relief and increased range of motion.Compared with preoperative ones，the last follow-up Harris score，excellent and good rate were obviously improved(P＜0.05).Conclusion Surgical dislocation of the hip for the treatment of femoral head osteonecrosis at early stage achieves good short-term outcomes，with the advantages of simplification of less complication and a whole vision of the acetabulum and femoral head.However，long-term clinical results still need by further follow-up.

Key words： surgical hipdislocation pre-collapse femoral head necrosis orthopedic procedures

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2018/V24/I9/769

［1］Kang JS，Moon KH，Kwon DG，et al.The natural history of asymptomatic osteonecrosis of the femoral head［J］.Int Orthop，2013，37(3)：379-384.
［2］Mont MA，Zywiel MG，Marker DR，et al.The natural history of untreated asymptomatic osteonecrosis of the femoral head：a systematic literature review［J］.J Bone Joint Surg(Am)，2010，92(12)：2165-2170.
［3］Wang B，Zhao D，Guo L，et al.Influencing factors of disease progression for asymptomatic osteonecrosis of the femoral head［J］.Zhonghua Yixue Za zhi，2014，94(21)：1627-1630.
［4］Min BW，Song KS，Cho CH，et al.Untreated asymptomatic hips in patients with osteonecrosis of the femoral head［J］.Clin Orthop Relat Res，2008，466(5)：1087-1092.
［5］Hernigou P，Habibi A，Bachir D，et al.The natural history of asymptomatic osteonecrosis of the femoral head in adults with sickle cell disease［J］.J Bone Joint Surg(Am)，2006，88(12)：2565-2572.
［6］Kuroda Y，So K，Goto K，et al.Extremely early stage osteonecrosis of the femoral head in a patient with hip pain secondary systemic steroid pulse therapy for Vogt-KoyanagiHarada syndrome：A case report［J］.Int J Surg Case Rep，2016(25)：97-101.
［7］Kubo Y，Motomura G，Ikemura S，et al.Effect of collapse on the deformity of the femoral head-neck junction in osteonecrosis of the femoral head［J］.Arch Orthop Trauma Surg，2017，137(7)：933-938.
［8］Kubo Y，Yamamoto T，Motomura G，et al.Patient-reported outcomes of femoral osteotomy and total hip arthroplasty for osteonecrosis of the femoral head：a prospective case series study［J］.Springerplus，2016，5(1)：1880.
［9］Kianmehr N，Bidari A，Mofidi M，et al.Silent osteonecrosis of the femoral head following high-dose corticosteroids in patients with systemic rheumatic diseases［J］.Med J Islam Repub Iran，2015(29)：259.
［10］Nakamura J，Kishida S，Harada Y，et al.Inter-observer and intra-observer reliabilities of the Japanese ministry of health，labor and welfare type classification system for osteonecrosis of the femoral head［J］.Mod Rheumatol，2011，21(5)：488-494.
［11］Barnsley L，Barnsley L，Page R.Are hip precautions necessary post total hip arthroplasty? A systematic review［J］.Geriatr Orthop Surg Rehabil，2015，6(3)：230-235.
［12］赵德伟，胡永成.成人股骨头坏死诊疗标准专家共识(2012年版)［J］.中国医学前沿杂志(电子版)，2012(11)：51-56.
［13］Mcminn DJ，Roberts P，Forward GR.A new approach to the hip for revision surgery［J］.J Bone Joint Surg(Br)，1991，73(6)：899-901.
［14］Sorel JC，Facee SM，Homan AS，et al.Surgical hip dislocation according to Ganz for excision of osteochondromas in patients with multiple hereditary exostoses［J］.Bone Joint J，2016，98(2)：260-265.
［15］朱威宏，毛新展，王万春，等.髋关节外科脱位入路在髋关节良性疾病的应用［J］.中国现代医学杂志，2016(16)：76-80.
［16］吴奇.髋关节外科脱位治疗髋关节撞击征的解剖和临床研究［D］.西安：第四军医大学，2015.
［17］孙大铭，张洪.髋关节外科脱位：充分、安全的髋关节显露［J］.中国骨肿瘤骨病，2011(5)：464-467.
［18］Ganz R，Gill TJ，Gautier E，et al.Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis［J］.J Bone Joint Surg(Br)，2001，83(8)：1119-1124.
［19］Gautier E，Ganz K，Krugel N，et al.Anatomy of the medial femoral circumflex artery and its surgical implications［J］.J Bone Joint Surg(Br)，2000，82(5)：679-683.
［20］Shin SJ，Kwak HS，Cho TJ，et al.Application of Ganz surgical hip dislocation approach in pediatric hip diseases［J］.Clin Orthop Surg，2009，1(3)：132-137.
［21］张洪，蒋毅，吕明，等.髋关节撞击综合征的诊断和治疗［J］.中华关节外科杂志(电子版)，2009(3)：352-357.
［22］Sankar WN，Matheney TH，Zaltz I.Femoroacetabular impingement：current concepts and controversies［J］.Orthop Clin North Am，2013，44(4)：575-589.