科研之友
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摘要
In periacetabular osteotomy for the treatment of developmental dysplasia of the hip, impairments in ADL due to limitations in hip flexion can occur when anterior displacement is added to lateral displacement in order to obtain sufficient femoral head coverage. This study was conducted to determine, by the range of motion (ROM) simulation based on CT images, the minimum angle of hip flexion and internal rotation at 90A degrees of flexion that is necessary to avoid ADL impairments after eccentric rotational acetabular osteotomy (ERAO) and to estimate the angles of anterior femoral head coverage on plain radiography that enable the above flexion. %26lt;br%26gt;Of 47 hips treated with ERAO at our hospital from December 2007 to May 2012, 27 hips without progressive osteoarthritis which could be CT scanned were examined and included. The mean age at the time of surgery was 40.7 years (SD 1.8). The postoperative follow-up period was 30.2 months (SD 3.6). Two hips were in male patients and 25 hips were in female patients. The disease stage prior to surgery was pre-osteoarthritis in 5 hips, early in 11 hips, and progressive in 11 hips. We checked whether the patients were capable of activities that require deep hip flexion for the evaluation of postoperative ADL. Radiographic examination was performed before and one year after surgery to calculate LCE angle, Sharp angle, AHI, and VCA angle. The angle at which impingement of the displaced fragment of the bone and the femur appeared was measured using 3D CAD software, and the relationship between this angle and the physical findings, ADL impairment, or radiographic findings, were also examined. %26lt;br%26gt;22 out of 27 hips that were capable of 116A degrees or more of flexion or 42A degrees or more of internal rotation at 90A degrees of flexion in ROM simulation showed the absence of ADL impairment and a postoperative VCA angle a parts per thousand currency sign42A degrees, whereas 5 hips with 110A degrees or less of flexion or 40A degrees or less of internal rotation at 90A degrees of flexion in ROM simulation had ADL impairments associated with limitations in hip flexion and a postoperative VCA angle a parts per thousand yen46A degrees. %26lt;br%26gt;Anterior and lateral coverage requires a postoperative VCA angle of a parts per thousand yen20A degrees to achieve anterior structural stability and an LCE angle of %26gt; 25A degrees to obtain adequate superior lateral coverage of the femoral head. A VCA angle a parts per thousand currency sign42A degrees is required to avoid impingement during deep flexion. A VCA angle a parts per thousand yen46A degrees is a probable risk factor for pincer FAI syndrome after ERAO.
- 出版日期2014-9
