変形性股関節症に対する大腿骨骨切り術とリハビリテーション : —関節適合性と術後荷重について—

概要

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In Japan, most of the osteoarthritis of the hip is secondary due to congenital dislocation of the hip or acetabular dysplasia. Total hip arthroplasty is generally performed as the operative method for treating hip osteoarthritis, but conservative operative methods are recommended for younger patients. Joint congruity is judged good for the hip joint in which the joint surface of the femoral head is parallel to the acetabular joint surface. In the case of an incongruent hip joint, the load concentrates and becomes larger per unit area of the joint. Joint incongruence is found in the early or advanced stage of the hip osteoarthritis. The femoral osteotomy should be performed when joint congruity is improved in the hip abduction or adduction position. Walking exercise begins 2 or 3 days postoperatively, and passive motion exercise is performed as soon as possible. Weight bearing on the operated hip should be limited for the protection of the joint cartilage. In the case of preserving joint space preoperatively, walking with a single crutch is allowed 2 or 3 months after the operation. If there was no or only a narrow joint space before the operation, it is recommended that two crutches be retained for 6 months and that one crutch then be used for another 6 months. Good results in clinical and radiological findings are maintained in 80% or more 10 years after the operation.