고관절 이형성증에서 시행한 비구주위 절골술의 단기 추시 결과
Short-Term Follow-up Results of Periacetabular Osteotomy for Hip Dysplasia Youn-Soo Park, MD1, Young-Wan Moon, MD1, Seung-Jae Lim
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목적: 비구 이형성증 환자에서 시행한 비구주위 절골술의 임상적 및 방사선학적 결과를 보고하고 자 한다. 대상 및 방법: 비구주위 절골술을 시행 받고 1년 이상 추시 가능하였던 19명 20고관절을 대상으 로 수술 전후의 임상 및 방사선학적 소견을 비교 분석하였다. 수술 당시 환자의 평균 연령은 34.2 세(18~50세)이었으며, 술 후 평균 추시 기간은 26.7개월(12~85개월)이었다. 임상적 평가는 Harris 고관절 점수를 이용하였으며, 방사선적 평가로는 비구각, CE 각, 비구 깊이, 대퇴골두 피 복 정도, 대퇴골두의 내측 전이의 변화를 비교하였다. 결과: Harris 고관절 점수는 술 전 59.6점에서 최종 추시시 96.4점으로 향상되었다. 비구 각은 술 전47.9에서 26.4로, CE 각은 14.2에서 41로, 비구 깊이는 176에서 242.7로, 대퇴골두 피복 은 63.3%에서 95.4%로 호전을 보였다. 합병증으로는 혈종 발생 2예, 일시적 대퇴부 이상 감각 3 예, 표재성 감염 1예가 있었다. 결론: 비구 이형성증 환자에서 비구주위 절골술은 임상 및 방사선학적 호전을 보이는 효과적인 수술 방법이다.
Abstract
Purpose: To evaluate the clinical and radiologic results of periacetabular osteotomy for the treatment of hip dysplasia. Materials and Methods: We performed a clinical and radiological assessment of 20 periacetabular osteotomies (19 patients), which had been followed up for > 1 year. The mean age of the patients at the time of surgery was 34.2 years (range, 18~50 years). The average follow-up period was 26.7 months (range, 12~85 months). The Harris hip score and range of motion were used for clinical evaluation. The radiologic measurements were evaluated using the acetabular angle, center-edge angle, acetabular depth, femoral head coverage, and medialization. Results: The mean Harris hip score improved from 59.6 points to 96.4 points. The mean acetabular angle improved from 47.9to 26.4. The mean center-edge angle increased from 14.2to 41. The acetabular depth increased from 176 to 242.7 The mean femoral head coverage increased from 63.3% to 95.4%. The following complications were noted: hematoma in 2 cases, temporary lateral femoral cutaneous nerve palsy in 3 cases, and superficial wound infection in 1 case. Conclusion: Periacetabular osteotomy is an effective surgical treatment for hip dysplasia.
참고문헌 (21)
- Cooperman DR, "Acetabular dysplasia in the adult", Clin Orthop Relat Res, 175, pp.79~85 (1983)
- Crockarell J, Jr, "Early experience and results with the periacetabular osteotomy. The Mayo Clinic experience", Clin Orthop Relat Res, 363, pp.45~53 (1999)
- Davey JP, "Complications of periacetabular osteotomy", Clin Orthop Relat Res, 363, pp.33~37 (1999)
- Ganz R, "A new periacetabular osteotomy for the treatment of hip dysplasias. Technique and preliminary results", Clin Orthop Relat Res, 232, pp.26~36 (1988)
- Hussell JG, "A comparison of different surgical approaches for the periacetabular osteotomy", Clin Orthop Relat Res, 363, pp.64~72 (1999)
- Hussell JG, "Technical complications of the Bernese periacetabular osteotomy", Clin Orthop Relat Res, 363, pp.81~92 (1999)
- Ko JY, "Periacetabular osteotomy through a modified ollier transtrochanteric approach for treatment of painful dysplastic hips", J Bone Joint Surg, 84-A, pp.1594~1604 (2002)
- Matta JM, "Periacetabular osteotomy through the Smith-Petersen approach", Clin Orthop Relat Res, 363, pp.21~32 (1999)
- Mayo KA, "Results of periacetabular osteotomy in patients with previous surgery for hip dysplasia", Clin Orthop Relat Res, 363, pp.73~80 (1999)
- Millis MB, "Osteotomies of the hip in the prevention and treatment of osteoarthritis", Instr Course Lect, 41, pp.145~154 (1992)
- Murphy SB, "The prognosis in untreated dysplasia of the hip. A study of radiographic factors that predict the outcome", J Bone Joint Surg, 77-A, pp.985~989 (1995)
- Murphy SB, "Acetabular dysplasia in the adolescent and young adult", Clin Orthop Relat Res, 261, pp.214~223 (1990)
- Murphy SB, "Surgical correction of acetabular dysplasia in the adult. A Boston experience", Clin Orthop Relat Res, 363, pp.38~44 (1999)
- Myers SR, "Anterior femoroacetabular impingement after periacetabular osteotomy", Clin Orthop Relat Res, 363, pp.93~99 (1999)
- Naito M, "Curved periacetabular osteotomy for treatment of dysplastic hip", Clin Orthop Relat Res, 433, pp.129~135 (2005)
- Ninomiya S, "Rotational acetabular osteotomy for the dysplastic hip", J Bone Joint Surg, 66-A, pp.430~436 (1984)
- Siebenrock KA, "Bernese periacetabular osteotomy", Clin Orthop Relat Res, 363, pp.9~20 (1999)
- Takatori Y, "Bernese periacetabular osteotomy", Clin Orthop Relat Res, 387, pp.245~246 (2001)
- To¨ nnis D, "Congenital dysplasia and dislocation of the hip in children and adults", pp.370~381 (1987), Springer-Verlag
- Trousdale RT, "Periacetabular and intertrochanteric osteotomy for the treatment of osteoarthrosis in dysplastic hips", J Bone Joint Surg, 77-A, pp.73~85 (1995)
- Trumble SJ, "The periacetabular osteotomy. Minimum 2 year followup in more than 100 hips", Clin Orthop Relat Res, 363, pp.54~63 (1999)
