Application of Adductor Amputation in Osteonecrosis of Femoral Head With Hip Abductor Function Limited_West China Medical Journal

Authors：

 CHENYu ,  ZHOUZong-ke , SHENBin , YANGJing , KANGPeng-de , PEIFu-xing

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHOUZong-ke, Email: zongke@126.com

Keywords：

Total hip arthroplasty; Adductor amputation; Range of the motion; Therapeutic effect

DOI：

10.7507/1002-0179.20150581

Video：

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Objective To explore the therapeutic effect of total hip arthroplasty (THA) and hip adductor amputation (HAA) in the surgical treatment of osteonecrosis of femoral head. Methods A total of 74 patients with osteonecrosis of femoral head with hip adduction deformity were included between June 2011 and May 2012. Among them, 38 patients had undergone THA, and 36 patients had undergone THA+HAA. Statistics about hip abductor function and Harris scores before and 1 week and 12 months after the surgery were recorded. SPSS 19.0 was used for statistical analysis. Results The patients' wounds had the Ⅰ-stage healing in both of the two groups. Two patients had scrotum swelling in THA+HAA group, who left the hospital after treating. One week after the surgery, the hip passive abduction angles increased (32.1±2.8) and (19.7±3.3)°, respectively in the THA+HAA group and THA group, while the Harris hip score increased 45.8±2.8 and 40.9±2.3, respectively; 12 months postoperatively, the hip passive abduction angles increased (32.2±0.9) and (26.8±2.8)°, respectively in the THA+HAA group and THA group, while the Harris hip score increased 52.7±7.2 and 49.4±4.4, respectively. The above comparative differences was statistically significant (P<0.05). Conclusion The surgical method of adductor amputation can improve the range of motion of the hip, raise the quality of life of the patients with osteonecrosis of the femoral head after the surgery.

Citation： CHENYu, ZHOUZong-ke, SHENBin, YANGJing, KANGPeng-de, PEIFu-xing. Application of Adductor Amputation in Osteonecrosis of Femoral Head With Hip Abductor Function Limited. West China Medical Journal, 2015, 30(11): 2046-2049. doi: 10.7507/1002-0179.20150581 Copy

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17.	Enaran H, Bowen JR, Harcke HT. Avascular necrosis rate in early reduction after failed Pavlik harness treatment of developmental dysplasia of the hip[J]. J Pediatr Orthop, 2007, 27(2):192-197.
18.	袁汝均, 郝永康. 內收肌切斷術、閉孔神經切斷術及股骨頭鉆孔減壓術治療股骨頭缺血壞死的體會[J]. 現代中西醫結合雜志, 2010, 19(7):841-842.
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21.	劉建啟, 梁棟, 崔曉方, 等. 內收肌髂腰肌切斷手法復位治療小兒先天性髖脫位[J]. 臨床骨科雜志, 2000, 3(1):30-31.

1. 李子榮. 科學診斷和治療股骨頭壞死[J]. 中國修復重建外科雜志, 2005, 19(9):685-686.
2. Hungerford DS. Treatment of osteonecrosis of the femoral head:everything’s new[J]. J Arthroplasty, 2007, 22(4 Suppl):91-94.
3. Bhave A, Marker DR, Seyler TM, et al. Functional problems and treatment solutions after total hip arthroplasty[J]. J Arthroplasty, 2007, 22(6 Suppl 2):116-124.
4. Alberton GM, High WA, Morrey BF. Dislocation after revision total hip arthroplasty:an analysis of risk factors and treatment options[J]. J Bone Joint Surg Am, 2002, 84-A(10):1788-1792.
5. Angliss R, Fujii G, Pickvance E, et al. Surgical treatment of late developmental displacement of the hip. Results after 33 years[J]. J Bone Joint Surg Br, 2005, 87(3):384-394.
6. 王宵光, 王淙清. 內收肌切斷預防全髖置換術后脫位[J]. 中醫正骨, 2008, 20(1):16, 80.
7. Pap K, Kiss S, Vízkelety T, et al. Open adductor tenotomy in the prevention of hip subluxation in cerebral palsy[J]. Int Orthop, 2005, 29(1):18-20.
8. Min BW, Lee KJ, Song KS, et al. Highly cross-linked polyethylene in total hip arthroplasty for osteonecrosis of the femoral head:a minimum 5-year follow-up study[J]. J Arthroplasty, 2013, 28(3):526-530.
9. Bradway JK, Morrey BF. The natural history of the silent hip in bilateral atraumatic osteonecrosis[J]. J Arthroplasty, 1993, 8(4):383-387.
10. Moya-Angeler J, Gianakos AL, Villa JC, et al. Current concepts on osteonecrosis of the femoral head[J]. World J Orthop, 2015, 6(8):590-601.
11. Chan GK, Duque G. Age-related bone loss:old bone, new facts[J]. Gerontology, 2002, 48(2):62-71.
12. Kirkland JL, Tchkonia T, Pirtskhalava T, et al. Adipogenesis and aging:does aging make fat go MAD?[J]. Exp Gerontol, 2002, 37(6):757-767.
13. 康鵬德, 裴福興, 王坤正. 股骨頭壞死的研究和治療進展[J]. 中國骨與關節損傷雜志, 2005 (1):65-68.
14. 趙海燕, 夏亞一, 康鵬德. 股骨頭壞死病因與發病機制研究進展[J]. 中國矯形外科雜志, 2009(8):604-607.
15. Lieberman JR, Berry DJ, Mont MA, et al. Osteonecrosis of the hip:management in the 21st century[J]. Instr Course Lect, 2003, 52:337-355.
16. Cheng EY, Thongtrangan I, Laorr A, et al. Spontaneous resolution of osteonecrosis of the femoral head[J]. J Bone Joint Surg Am, 2004, 86-A(12):2594-2599.
17. Enaran H, Bowen JR, Harcke HT. Avascular necrosis rate in early reduction after failed Pavlik harness treatment of developmental dysplasia of the hip[J]. J Pediatr Orthop, 2007, 27(2):192-197.
18. 袁汝均, 郝永康. 內收肌切斷術、閉孔神經切斷術及股骨頭鉆孔減壓術治療股骨頭缺血壞死的體會[J]. 現代中西醫結合雜志, 2010, 19(7):841-842.
19. 劉雙, 張立軍, Kiss S, 等. 應用“A”型外展支具治療股骨頭缺血性壞死療效分析[J]. 中國矯形外科雜志, 2014, 22(7):593.
20. 羅錕, 董曉俊. 針刀松解髖關節內側關節囊對ANFH外展功能的影響[J]. 中國中醫骨傷科雜志, 2011, 19(7):23-24.
21. 劉建啟, 梁棟, 崔曉方, 等. 內收肌髂腰肌切斷手法復位治療小兒先天性髖脫位[J]. 臨床骨科雜志, 2000, 3(1):30-31.

West China Medical Journal

Application of Adductor Amputation in Osteonecrosis of Femoral Head With Hip Abductor Function Limited

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