摘要
目的综述青少年及成人发育性髋关节发育不良(developmental dysplasia of the hip,DDH)有关的影像学评估、治疗进展与争议。方法查阅近年国内外有关青少年与成人DDH有关的热点问题,包括影像学评估软骨的新技术、对临界DDH(borderline DDH,BDDH)诊断及治疗的争议以及髋臼周围截骨术(peracetabular osteotomy,PAO)技术的改进与展望,并进行总结分析。结果DDH是导致髋关节骨关节炎的主要因素之一,随着对DDH病理改变认识不断加深,利用延迟钆增强的软骨磁共振成像技术可以进一步评估骨关节炎进展并预测保髋手术的预后。有关BDDH的诊断和治疗方法选择仍有争论,同时PAO手术技术与理念仍在不断完善与改进中。结论软骨损伤情况与骨性结构决定了保髋手术方式与术后预后。青少年及成人DDH的保髋之路将朝着个体化、精准化的目标前进。
Objective To review the imaging evaluation,treatment progress,and controversy related to developmental dysplasia of the hip(DDH)in adolescents and adults.Methods The domestic and abroad hot issues related to adolescents and adults with DDH in recent years,including new imaging techniques for assessing cartilage,controversies over the diagnosis and treatment of borderline DDH(BDDH),and the improvement and prospect of peracetabular osteotomy(PAO)were summarized and analyzed.Results DDH is one of the main factors leading to hip osteoarthritis.As the understanding of the pathological changes of DDH continues to deepen,the use of delayed gadolinium-enhanced MRI of cartilage can further evaluate the progress of osteoarthritis and predict the prognosis after hip preservation.There are still controversies about the diagnosis and treatment of BDDH.At the same time,PAO technology and concepts are still being improved.Conclusion Cartilage injury and bony structure determine the choice of surgical methods and postoperative prognosis of hip preservation surgery.The hip preservation of adolescent and adult DDH patients will move towards the goal of individualization and accuracy.
作者
吴尽言
陈晓东
WU Jinyan;CHEN Xiaodong(Shanghai Jiao Tong University School of Medicine,Shanghai,200025,P.R.China;Department of Orthopedics,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200092,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2021年第12期1513-1518,共6页
Chinese Journal of Reparative and Reconstructive Surgery
