Hip & pelvis

  • 제22권1호
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  • Pages.38-44
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  • 2010
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  • 2287-3260(pISSN)
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  • 2287-3279(eISSN)
대한고관절학회 (The Korean Hip Society)
권호 표지

이형성된 비구에서 비구 내측벽 전위 절골술을 이용한 인공고관절 전치환술

Acetabular Medial Wall Displacement Osteotomy in Total Hip Arthroplasty for Dysplastic Hips

  • 권석현 (원광대학교 의과대학 정형외과학교실) ;
  • 한홍준 (익산 병원 관절센터) ;
  • 이영 (원광대학교 의과대학 정형외과학교실)
  • Kweon, Seok-Hyun (Department of Orthopedic Surgery, College of Medicine, Wonkwang University) ;
  • Han, Hong-Jun (Center for Joint Disease, Iksan Hospital) ;
  • Yi, Young (Department of Orthopedic Surgery, College of Medicine, Wonkwang University)
  • 발행 : 2010.03.31
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 이형성된 비구를 가진 고관절 질환에서 비구 내측벽 전위 절골술 후 인공 고관절 전치환술을 시행한 치료 결과를 보고하고자 한다. 대상 및 방법: 1999년 3월부터 2002년 10월까지 선천성 고관절 탈구증이나 비구 이형성증 등으로 인한 이차성 고관절염으로 진단되어 고관절 전치환술 시행받은 30명, 30예를 임상적 및 방사선학적으로 평가하였다. 수술 당시 평균 연령은 465세(17~73세), 평균 추시 기간은 5년(53~87년)이었다 26예에서 무시멘트 반구형, 4예에서 비구 보강환을 이용하였다. 구조적 골이식술은 2예에서 시행하였다. 결과: Harris 고관절 점수는 술 전 평균 563점에서 최종 추시상 932점으로 향상되었다 방사선 분석상 최종 추시에 비구측 삽입물의 해리나 방사선 투과선은 없었으며, 모두 안정된 골성 고정을 보였다. 절골 전위된 내측 비구골 두께는 평균 205 mm (10~36 mm)이었으며, 술 후 평균 4개월에 골유합을 보였다. 결론: 이형성된 비구를 가진 고관절 질환에서 비구 내측벽의 전위 절골술을 시행 후 인공 고관절 전치환술은 비구 내측벽을 보존하면서 비구 피복을 향상 시키고, 고관절 생역학을 향상시키는 좋은 술식으로 사료된다.

Purpose: This study evaluated the results of acetabular medial wall osteotomy to reconstruct the acetabulum in dysplastic hip during total hip arthroplasty. Materials and Methods: We clinically and radiologically evaluated 30 hips of 30 patients with secondary hip osteoarthritis caused by congenital hip dislocation or acetabular dysplasia who underwent total hip arthroplasty (THA) between March 1999 and October 2002. The average age of subjects was 46.5 years(17 to 73 years), and the mean follow-up period was 5 years(5.3 to 8.7 years). In 26 cases, a cementless hemispherical acetabular cup was inserted in the true acetabulum; in 4 cases a reinforced ring was inserted. Only 2 hips needed structural bone grafting. Results: The average Harris hip score improved from 56.3 points preoperatively to 93.2 points at the last follow up. Radiographic analysis revealed no aseptic loosening or radiolucent line, and showed stable bony fixation at the true acetabulum. The mean thickness of the medial acetabular wall postoperative was 20.5 mm(10 to 36 mm). Bone union of the medial wall was observed at a mean of four months postoperatively. Conclusion: Acetabular medial wall osteotomy can maintain the integrity of the acetabular medial wall while achieving enhanced acetabular coverage and more normal hip biomechanics.

키워드

참고문헌

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