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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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. 内收肌切断术、闭孔神经切断术及股骨头钻孔减压术治疗股骨头缺血坏死的体会[J]. 现代中西医结合杂志, 2010, 19(7):841-842.
19.	刘双, 张立军, Kiss S, 等. 应用“A”型外展支具治疗股骨头缺血性坏死疗效分析[J]. 中国矫形外科杂志, 2014, 22(7):593.
20.	罗锟, 董晓俊. 针刀松解髋关节内侧关节囊对ANFH外展功能的影响[J]. 中国中医骨伤科杂志, 2011, 19(7):23-24.
21.	刘建启, 梁栋, 崔晓方, 等. 内收肌髂腰肌切断手法复位治疗小儿先天性髋脱位[J]. 临床骨科杂志, 2000, 3(1):30-31.

1. 李子荣. 科学诊断和治疗股骨头坏死[J]. 中国修复重建外科杂志, 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. 内收肌切断预防全髋置换术后脱位[J]. 中医正骨, 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. 康鹏德, 裴福兴, 王坤正. 股骨头坏死的研究和治疗进展[J]. 中国骨与关节损伤杂志, 2005 (1):65-68.
14. 赵海燕, 夏亚一, 康鹏德. 股骨头坏死病因与发病机制研究进展[J]. 中国矫形外科杂志, 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. 内收肌切断术、闭孔神经切断术及股骨头钻孔减压术治疗股骨头缺血坏死的体会[J]. 现代中西医结合杂志, 2010, 19(7):841-842.
19. 刘双, 张立军, Kiss S, 等. 应用“A”型外展支具治疗股骨头缺血性坏死疗效分析[J]. 中国矫形外科杂志, 2014, 22(7):593.
20. 罗锟, 董晓俊. 针刀松解髋关节内侧关节囊对ANFH外展功能的影响[J]. 中国中医骨伤科杂志, 2011, 19(7):23-24.
21. 刘建启, 梁栋, 崔晓方, 等. 内收肌髂腰肌切断手法复位治疗小儿先天性髋脱位[J]. 临床骨科杂志, 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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