You are here

Genç Erişkin Kalça Displazisinde Ganz Periasetabular Osteotomisi

Ganz Periacetabular Osteotomy For Young Adult Hip Dysplasia

Journal Name:

Publication Year:

Abstract (2. Language): 
Acetabular dysplasia is a complex multi-plane deformity of the acetabulum, which results in the development of osteoarthritis at an early age in young adults. Our study on patients who had undergone a Ganz periacetabular osteotomy aimed to radiologically examine the amount of femoral head coverage post osteotomy, and to research the effects on clinical function and the development of osteoarthritis. The study comprised 13 hips on which Ganz periacetabular osteotomy had been performed between May 2003 and March 2008, from 12 patients diagnosed with acetabular dysplasia. One patient was not included in the evaluation because of infection. All patients had pre and postoperative AP pelvis radiographs showing the amount of femoral head coverage, and measurements were taken of anterior and posterior femoral head coverage, CE angle, length difference, and the difference in the sagittal and horizontal plane of the teardrop. The degeneration of the hip joint was evaluated according to the Tonnis Hip Classification and function by Harris Hip Score. The differences in CE angle, amount of femoral head coverage, amount of anterior coverage and Harris Hip Score were found to be statistically significant. In conclusion, a significant decrease in hip pain was observed in patients who had undergone a Ganz periacetabular osteotomy. The increase in femoral head coverage creates a biomechanically better functioning hip thus enhancing the quality of life for the patient, therefore Ganz periacetabular osteotomy can be considered an effective technique.
Abstract (Original Language): 
Asetabular displazi; genç erişkinlerde erken yaşta osteoartrit gelişimi ile sonuçlanabilecek asetabulumun çok plandaki deformitesidir. Çalış- mamızda, osteotomi uygulanan hastalarda ameliyat sonrası radyolojik olarak femur başı örtüm miktarı, osteoartrit gelişimi ve bunun klinik olarak fonksiyonel durum üzerine olan etkisinin araştırılması amaçlanmıştır. Mayıs 2003 ile Mart 2008 tarihleri arasında asetabular displazisi olan 12 hastanın 13 kalçasına Ganz periasetabular osteotomi uygulandı. Hastaların ameliyat öncesi ve sonrası çekilen ön arka pelvis grafileri ile femur başının örtüm miktarı, CE açısı, uzunluk farkı, teardrop’ın sagittal ve horizontal planda değişiklik miktarı ölçüldü. Hastalardaki kalça eklem dejenerasyon miktarı Tönnis kalça sınıflandırmasına, eklemin fonksiyonel durumu ise Harris kalça skoruna göre değerlendirildi. İstatiksel olarak CE açıları, femur başı örtüm miktarı ve Harris kalça skorundaki değişiklikler anlamlı bulundu. Sonuç olarak Ganz periasetabular osteotomisi uygulanan hastaların kalça ağrılarında anlamlı bir azalma gözlendi. Bunun osteotomi sonrası femur başı örtüm miktarının artması ile yaşam kalitesini artırıcı fonksiyonel bir kalça biyomekaniği oluşturulmasından ileri geldiği kanısına varıldı.
41-45

REFERENCES

References: 

1. Steel H H.Triple osteotomy of the innominate bone. J
BoneJoint Surg 1973; 55-A (4): 343-50.
2. Sutherland D H, Greenfield R. Double innominate osteotomy.J
Bone Joint Surg 1977; 59-A (4): 1082-91.
3. Salter RB. Innominate osteotomy in the treatment of congenital
dislocation and subluxation of the hip. J Bone Joint Surg 1961;
43-B: 518-39.
4. Chiari K. Medial diplacement osteotomi of the pelvis. Clin
Orthop 1974; 98: 55-71
5. Murphy S, Deshmukh R. Periasetabular osteotomi: preoperative
radiographic predictors of outcome. Clin. Orthop 2002; 405:
168-174
6. Crockarell J, Trousdale R T,Cabanella M E, Berry D J. Early
experience and results with the periacetabular osteotomy. The
Mayo Clinic experience. Clin Orthop 1999; 363: 45-53
7. Trumble S J, Mayo K A, Mast J W. The periacetabular
osteotomy. Clin Orthop 1999; 363: 54-63
8. Matta M J, Stover M D, Siebenrock K. Periacetabular
osteotomy through the Smith-Petresen approach. Clin Orthop
1999; 363: 21-32
9. Siebenrock K A, Scholl E, Lottenbach M, Ganz R. Bernese
periacetabular osteotomy. Clin Orthop 1999; 363: 9-20
10. Soballe K. Pelvic osteotomy for acetabular dysplasia. Acta
Orthop Scand 2003; 74: 117-118
11. Wiberg G. A measuring method for distinguishing between a
normal and a maldeveloped acetabulum. Acta Chir Scand 1939;
83:28-38
12. Cooperman D R, Wallensten R, Stulberg S D. Asetabular
dysplasia in the adult. Clin Orthop 1983; 175: 79-85
13. Wedge J H, Wasylenko M J. The natural history of congenital
disease of the hip. J Bone Joint Surg (Br) 1979; 61: 334-338
14. Bombeli R. Mechanics of the normal and osteoarthritic hip.
Clin Orthop 1984; 182: 69-72
15. Mechlenburg İ, Kold S, Romer L, Sobele K. Safe fixation with
two acetabular screws after Ganz periacetabular osteotomy.,
Acta Orthop 2007;78 (3):344-349
16. Sucato D J Treatment of late dysplasia with Ganz osteotomy..
Clin Orthop N Am. 2006; 37: 161-171
17. Trousdale R T, Cabanela M E. Lessons learned after more than
250 periacetabular osteotomies. Acta Orthop. Scand 2003;74
(2): 119-126
18. Mechlenburg İ, Nyengaard J, Romer L, Sobele K. Changes in
load-bearing area after Ganz periacetabular osteotomy
evaluated by multislice CT scanning and stereology. Acta
Orthop Scand 2004; 75 (2): 147-153
19. Kralj M, Mavcic B, Antolic V, Iglic A, İglic V K. The Bernese
periacetabular osteotomy:clinical, radiografic and mechanical
7-15 year follow-up of 26 hips. Acta Orthop 2005; 76 (6): 833-
840 Genç Erişkin Kalça Displazisinde Ganz
45
20. Clohisy J C, Barrett S E, Gordon J E, Delgado E D,
Schoenecker P L. Medial translation of the hip joint center
associated with the Bernese periacetabular osteotomy. The Iova
orthopaedic Journal
21. Ganz R, Klaue K, Vinh T S, Mast J W. A new periacetabular
osteotomy for the treatment of hip dysplasias. Technique and
preliminary results. Clin Orthop 2004; 418: 3-8
22. Ganz R, Klaue K, Vinh T S, Mast J W. A new periacetabular
osteotomy for the treatment of hip dysplasias. Clin Orthop
1988; 232: 26-36
23. Wagner H. Osteotomies for congenital hip dislocation. In The
hip society 4th annual meeting. CV Mosby, St Louis, 1976: 45-
66.
24. Pogliacomi F, Stark A, Vaienti E, Wallensten R. Periacetabular
osteotomy of the hip: the ilioinguinal approach. Acta Biomed.
2003 Apr;74(1):38-46
25. Troelsen A, Mechlenburg I, Gelineck J, Bolvig L, Jacobsen S,
Søballe K.What is the role of clinical tests and ultrasound in
acetabular labral tear diagnostics. Acta Orthop. 2009 Jan 1:1

Thank you for copying data from http://www.arastirmax.com