Risk factors for lateralization or superiorization of the center of the femoral head in eccentric rotational acetabular osteotomy

IF 1.5 4区 医学 Q3 ORTHOPEDICS
Masanori Okamoto , Yasuhiko Takegami , Yusuke Osawa , Hiroki Iida , Hiroto Funahashi , Taisuke Seki , Shiro Imagama
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引用次数: 0

Abstract

Purpose

This study aimed to clarify the factors that cause the lateralization and superiorization of the femoral head after eccentric rotational acetabular osteotomy (ERAO) by examining the three-dimensional morphology of the osteotomy site using computed tomography (CT).

Methods

This study included 52 patients who underwent ERAO for hip dysplasia. Postoperatively, the center of the femoral head was measured for lateralization and superiorization. We defined the iliac and sciatic osteotomy angles in the coronal and axial CT planes, respectively. The surgical factors for lateralization and superiorization were analysed using multiple logistic regression analysis. We also analysed the relationship between the femoral head relocation and clinical outcomes (as assessed using Japanese Orthopaedic Association (JOA) scores).

Results

Thirty-five patients had hips with lateralized femoral heads, and 25 patients’ femoral heads were superiorized. Logistic regression analysis revealed that a higher osteotomy angle of the ilium in the coronal plane served as a significant predictor of superiorization of the femoral head. Similarly, a larger osteotomy angle of the ischium in the axial plane and the amount of change in the lateral centre edge angle were identified as predictors of lateralization. A weak negative correlation was observed between the amount of lateralization and the JOA score.

Conclusion

Large osteotomy angles in the superior and posterior aspects of the acetabulum carry a risk of superiorization and lateralization of the center of the femoral head. Surgeons should be aware of the need to chisel through the internal plate to achieve the results described in the ERAO theory.

Study design

A single-center, retrospective study.

偏心旋转髋臼截骨术中股骨头中心侧移或上移的风险因素。
目的:本研究旨在通过使用计算机断层扫描(CT)检查截骨部位的三维形态,明确导致偏心旋转髋臼截骨术(ERAO)后股骨头外侧化和上移的因素:这项研究包括52名因髋关节发育不良而接受ERAO手术的患者。术后测量了股骨头中心的侧位和上位。我们分别在冠状和轴向 CT 平面上定义了髂骨和坐骨截骨角。我们采用多元逻辑回归分析法对股骨侧移和上移的手术因素进行了分析。我们还分析了股骨头移位与临床结果(使用日本骨科协会(JOA)评分进行评估)之间的关系:结果:35 名患者的髋关节股骨头侧移,25 名患者的股骨头上移。逻辑回归分析显示,髂骨在冠状面上的截骨角度越大,股骨头上移越明显。同样,轴向截骨角度较大的髂骨和外侧中心边缘角的变化量也是预测股骨头偏侧的因素。侧移量与 JOA 评分之间呈弱负相关:结论:髋臼上部和后部的大截骨角度存在股骨头中心上移和侧移的风险。外科医生应意识到需要凿穿内板才能达到ERAO理论中描述的效果:研究设计:单中心回顾性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
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