tailieunhanh - Nội soi trong điều trị loạn sản xương hông

Hip loạn sản vị thành niên và người lớn có thể được điều trị phẫu thuật bằng cách quay acetabulum vào một vị trí hỗ trợ trọng lượng tốt hơn, tuy nhiên, osteotomies mở vùng chậu là một trong những xâm lấn nhất của tất cả các thủ tục chỉnh hình trẻ em. Osteotomy vùng chậu nội soi cung cấp những lợi thế lý thuyết hình dung phóng to của việc cắt giảm xương | Perspectives on Modern Orthopaedics Endoscopic Pelvic Osteotomy for the Treatment of Hip Dysplasia Eric J. Wall MD Ron Kolata DVM Dennis R. Roy MD Charles T. Mehlman DO MPH and Aliin H. Craii 1 ord MD Abstract Adolescent and adult hip dysplasia can be surgically treated by rotating the acetabulum into a better weight-supporting position however open pelvic osteotomies are among the most invasive of all pediatric orthopaedic procedures. Endoscopic pelvic osteotomy offers the theoretical advantages of magnified visualization of the bone cuts minimized surgical dissection and rapid postoperative recovery. The technique of endoscopically assisted triple innominate osteotomy requires the combination of endoscopic skills and facility with more standard surgical approaches. J Am Acad Orthop Surg 2001 9 150-156 Osteoarthritis of the hip is a common disease in the United States affecting at least 1 million persons under age Total hip arthroplasty is not an ideal treatment for young adults with osteoarthritis because of problems with component loosening and premature wear. Many young patients in whom osteoarthritis of the hip will ultimately develop have an underlying mechanical abnormality of either the acetabulum or the proximal femur hip dysplasia . Early hip osteoarthritis frequently involves concentrated stress on the cartilage in a small portion of the hip-joint circumference typically the lateral acetabular margin. Rotational pelvic osteotomies distribute and decrease stress by enlarging the weight-bearing cartilage area of the acetabulum. Adults and adolescents with a hip center-edge angle of less than 16 degrees are at high risk for osteoarthritis especially when hip subluxation is Reconstructive hip joint osteotomies may forestall the onset of osteoarthritis in patients with dys-plastic hips and allow the postoperative return to high-impact work and sports. In adolescents and young adults with severe dysplasia who require an acetabular rotation of