Avtor/Urednik		Kralj, Marko
Naslov		Klinična, rentgenska in biomehanska analiza Ganzove trojne osteotomije medenice
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Univerza v Ljubljani, Medicinska fakulteta
Leto izdaje		2006
Obseg		str. 78
Jezik		slo
Abstrakt		Background: The aim of this study was the long-term clinical, radiographic and biomechanical evaluation of the Bernese periacetabular osteotomy in adult patients with residual hip dysplasia who underwent the procedure at the authors' institution between 1987 and 1995. Patients and Methods: Preoperative, postoperative and follow-up analysis was performed in 26 dysplastic hips 7-15 years after the index operation. Clinical evaluation was based on WOMAC score, hip osteoarthritis was evaluated with Tonnis classification and the angles of lateral (CE) and anterior (VCA) femoral coverage were measured. Biomechanical parameters (mean peak contact stress, resultant hip joint contact force, index of contact stress gradient) were computed with a previously developed biomechanical model. Results: The periacetabular osteotomy increased the mean CE angle from 15° to 37°, the mean VCA angle from 22° to 38°, the mean normalized peak contact stress was reduced from 5.2 to 3.0 kPa/N and the mean normalized index of contact stress gradient was reduced from +1.0 to -0.6 x 105 m-3. Four hips required total hip arthroplasty after mean 4.5 years, eight hips showed considerable osteoarthritis progression and fourteen hips had no or mild osteoarthritis at follow-up. Clinical outcome preoperatively and at follow-up was evaluated with Womac Osteoarthritis Index. The group of 8 patients with osteoarthritis progression had a Womac score of 72 points preoperatively to 35 points postoperatively. The group of 14 patients with no THR, no or mild osteoarthritis had increase of Womac score from 67 points preoperatively to 80 points postoperatively. ROM in 26 patients decreased from 158° preoperatively to 133° postoperatively. Conclusion: The Bernese periacetabular osteotomy improves biomechanical status of the hip. Long-term success depends on the preoperative osteoarthritis grade and the magnitude of operative correction of peak contact hip stress. (Abstract truncated at 2000 characters)
Deskriptorji		HIP DISLOCATION, CONGENITAL OSTEOTOMY BIOMECHANICS HIP PROSTHESIS OSTEOARTHRITIS, HIP ADULT DISABILITY EVALUATION HIP JOINT