未经授权:遗传性多发性外生体(HME)患者的获得性髋关节畸形可能发生在需要初次全髋关节置换术(THA)的早期髋关节骨关节炎和功能受限中。HME中特征性的股骨关节畸形可能对整形外科医生构成挑战。在这里,我们报告了在我们医院接受THA治疗的一系列HME患者的经验。
未经评估:平均随访5年,回顾了10例原发性THA;股骨近端畸形,髋臼发育不良和关节骨关节炎已通过X线和CT扫描评估。在所有情况下,都使用半球形压合杯;4个茎有干phy端接合,5例具有近端骨干接合,1例具有解剖学几何形状,有干phy端固定。2例需要茎胶结,3个模块化颈部和1个侧向。临床数据,并发症和临床结果,进行了记录和分析。
UNASSIGNED:平均Harris髋关节评分(HHS)从术前的34分增加到术后的86分;术前平均颈轴角(NSA)为150°,头颈比0.6,偏移31mm;Wiberg角28°,锐角38°,根据Crowe的说法,1例患者的半脱位为4级,8髋显示骨关节炎(Tönnnis等级2);5股骨被归类为DorrC型,2为B型,3为A型。未观察到围手术期并发症。
未经批准:HME中的原发性THA显著改善了临床和功能结局。压配合杯固定在一起,并在可靠的骨骼质量股骨上与干meta端和近端干茎接合,代表髋臼形态正常的HME患者的有效选择,宽大的脖子和外翻NSA。
UNASSIGNED: Acquired hip deformities in patients affected by hereditary multiple exostosis (HME) may incur in early hip osteoarthritis and functional limitation requiring primary total hip arthroplasty (THA). Characteristic coxo-femoral joint dysmorphisms in HME may pose a challenge for the orthopaedic surgeon. Here we report our experience in a series of patients with HME treated in our hospital with THA.
UNASSIGNED: With a mean follow-up of 5 years, 10 primary THAs were reviewed; proximal femur deformities, acetabular dysplasia and joint osteoarthritis has been assessed through x-rays and CT-scan evaluation. In all cases hemispheric press-fit cups were used; 4 stem had metaphyseal engagement, 5 had proximal diaphyseal engagement and 1, with anatomical geometry, had metaphyseal fixation. 2 cases required stem cementation, 3 modular neck and 1 lateralised. The clinical data, complications and clinical outcomes, were recorded and analysed.
UNASSIGNED: The mean Harris Hip Score (HHS) increased from 34 preoperative to 86 postoperative; preoperative mean neck shaft angle (NSA) was 150°, head/neck ratio 0.6, offset 31 mm; Wiberg angle 28°, Sharp angle 38°, 1 patient had subluxation grade 4 according to Crowe, 8 hips showed osteoarthritis (Tönnis grade ⩾2 ); 5 femurs were classified as Dorr type C, 2 as type B and 3 as type A. Perioperative complications were not observed.
UNASSIGNED: Primary THA in HME significantly improved clinical and functional outcomes. Press-fit cup fixation together with metaphyseal and proximal diaphyseal stem engagement on reliable bone quality femur, represents a valid option in HME patients with normal acetabular morphology, wide broaden neck and valgus NSA.