若年者の特発性大腿骨頭壊死症に対する大腿骨頭回転骨切り術の治療成績

スポンサーリンク

概要

• 論文の詳細を見る

• Objective: Because idiopathic osteonecrosis of the femoral head (ION) frequently develops in young adults, joint-preserving surgery is important. We retrospectively reviewed the clinical and radiographic results in patients who underwent transtrochanteric rotational osteotomy of the femoral head over a 5-year period in our institution.Methods: We were able to follow up 32 consecutive patients (25 male patients and 7 female patients. 38 hips) for a mean of 13.5 years. The average age was 37.7 years at the time of surgery. Using the Japanese Organizing Committee classification, the ION stage was 2 in 1 joint, 3A in 24 joints, and 3B in 13 joints. The necrotic type was C-1 in 6 joints and C-2 in 32 joints, according to the Japanese Organizing Committee classification. Patients were evaluated using the Japanese Orthopaedic Association Score (JOA score) and radiographic analysis.Results: The mean JOA score improved from 54.7 to 86.6 points (P < 0.0001) at the time of the final follow-up evaluation. Radiographically, the osteonecrosis in 26 hips (68%) had no progressive collapse, but 12 hips (32%) showed osteoarthritic changes and collapse. Six patients (eight hips) underwent total hip arthroplasty (THA). The postoperative intact area ratio (%) was significantly different between those with no progressive collapse (74.5%) and those with progressive collapse (45.4%) (P < 0.05). The cumulative survival rate was 75.6% at 13 years, with conversion to THA as the end point. Conclusion: In patients with extensive lesions, adequate rotation and intentional varus position is important to prevent the collapse of the transposed necrotic area.

• 日本関節病学会の論文

日本関節病学会 | 論文

• 関節リウマチ患者における手術と機能回復
• 低出力超音波刺激(LIPUS)および線維芽細胞増殖因子(FGF-2)の骨形成促進作用におけるヒアルロン酸(HA)の影響
• 変形性関節症に対するグルコサミン・コンドロイチンの有用性 (第36回[日本関節病]学会寄稿)
• 人工膝関節再置換術の経験--脛骨結節骨切り術の適応と合併症について
• RA頚椎病変に対する上位頚椎後方除圧固定術の治療成績と問題点

もっと見る

スポンサーリンク