小児・思春期からの関節症予防　　臼蓋回転骨切り術（ＲＡＯ）１０歳代に行った１０年以上追跡例の検討

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We report on the results of over ten years' experience of rotational acetabular osteotomy in patients from the age of 10 to 19 yr. We have performed the rotational acetabular osteotomy procedure using osteotomy of greater trochanter in 2700 hips since 1978.Period: The mean follow-up periods were 16.2 years (range, ten to twenty-five years) in pre-to early-stage patients, and 17.0 years (range, ten to twenty-three years) in advanced-to end-stage patients.Underlying diseases: One hundred sixty eight hips demonstrated congenital dislocation (63.4%), forty-eight showed acetabular dysplasia (18.1%), thirty had Perthes disease (11.3%), and seven had purulent arthritis. Four patients also had cerebral palsy. Patients from the age of 10 to 19 yr were characterized by the prevalence of congenital dislocation and a high percentage of these patients had undergone surgery, in many of whom trochanteric tractions had been performed.Results: The mean JOA score improved from 84.6 points pre-operatively to 95.0 points at follow-up in primary-to early-stage patients, and from 69.3 points to 88.6 points in advanced-or end-stage patients. THA was performed in two patients with bilateral or advanced disease.Conclusion: Rotational acetabular osteotomy in young patients showed good long-term results, and was effective for controlling the progress of coxarthrosis.
日本関節病学会の論文