進行期・末期変形性股関節症に対する外反骨切り術の長期成績

Long-term Results of Intertrochanteric Valgus Osteotomy for Progressive-stage and End-stage Osteoarthritis of the Hip

　当院における青壮年期の進行期・末期変形性股関節症に対する外反骨切り術の15年以上経過例の成績を報告する．対象は51例54股で，平均観察期間は17.2年であった．JOAスコア疼痛20点と人工股関節置換術移行をend pointとして生存率を調べ，年齢，術前・後acetabular head index（AHI），反対側股関節，骨反応の状態と生存率の関連について検討した．生存率は10年91％，15年63％となり，術後14～15年頃から急激に低下した．生存率と年齢，反対側の状態，骨反応状態には関連が示唆されたが，有意差は認めなかった．外反骨切り術の10年成績は安定し，青壮年期の進行期および末期の股関節症には有用な手術法である．

　Patients who underwent intertrochanteric valgus osteotomy for progressive-stage or end-stage osteoarthritis of the hip were followed up for 15 years or more. There were 51 patients, and valgus osteotomy had been performed on 54 hips. The average follow-up period was 17.2 years. The 10-and 15-year survival rates were 91％ and 63％, respectively (end point defined as a pain score of 20 points or less, of THA). The data suggested associations between survival rate and age, grade of osteoarthritis in the contralateral hip, and Bombelli classification of osteoarthritis, but no statistically significant differences were found. The results of intertochanteric valgus osteotomy were excellent according to the 10-year follow-up data, and it was beneficial for young patients with progressive-stage or end-stage osteoarthritis of the hip.