2024-03-28T13:26:48Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00020389
2022-12-15T03:51:07Z
453:456
471:537:538:1166
亜脱臼性変形性股関節症に対するBombelli外反伸展骨切り術の適応と限界
亜脱臼性変形性股関節症に対するBombelli外反伸展骨切り術の適応と限界
A Follow-up Study of Bombelli's Valgus Extension Osteomy for Osteoarthrosis of the Hip Joint due to Acetabular Dysplasia
湯朝, 信博
Bombelli's valgus extension osteotomy
osteoarthrosis of the hip joint
indication
Bombelli外反伸展骨切り術
変形性股関節症
適応
Bombelli's valgus extension osteotomy was performed on 68 patients, 66 females and 2 males, 74 joints with osteoarthrosis of the hip joint due to acetabular dysplasia. The operation was indicated in patients with radiological evidence of the capital drop, with widening of the lateral joint space on adduction, and with range of motion, more than 60° on flexion and than 15° on adduction. The average postoperative follow-up period was 5 years and 2 months, ranging 2 years to 9 years and 8 months. The results of the operative treatment were evaluated according to the JOA scoring system based on pain, gait, range of motion, ADL and X-ray findings. Also, arthroscopic observation and biopsy were carried out for the articular surface on the weight-bearing area of femoral head. Pain score significantly improved at the follow-up. But gait, range of motion, and ADL were unchanged. Of all the joints operated on, the outcome of the operation was evaluated as good in 64 joints (87%) and poor for the remaining 10 joints (13%). The mean score for postoperative pain in the patients, more than 6 years after operation, were 35 and 29 at the 2nd and the 6th year respectively. The results were estimated as good in patients with the following preoperative X-ray findings: (1) the width of base of the capital drop was more than 5mm, (2) acetabular head index was above 60% and/or the angle of acetabular tilting was 30° or less, or (3) the size of bone cyst within femoral head was less than 20mm. Arthroscopically, articular surface of weight-bearing area was covered with fibrous tissue. Histologically, this tissue was identified as fibrocartilage. However, since such repair of fibrocartilage is thought to be structurally and biomechanically weaker than innate hyaline cartilage. This is the reason why pain relief caused by Bombelli's osteotomy was to be reduced with the passage of time.
新潟医学会
1993-01
jpn
departmental bulletin paper
http://hdl.handle.net/10191/37053
https://niigata-u.repo.nii.ac.jp/records/20389
AN00182415
00290440
新潟医学会雑誌
新潟医学会雑誌
107
1
40
52
https://niigata-u.repo.nii.ac.jp/record/20389/files/107(1)_40-52.pdf
application/pdf
6.6 MB
2019-08-16