骨切り術が初回人工股関節全置換術に及ぼす影響

Impact of Osteotomy on the Results of Primary Total Hip Arthroplasty

　2008年1月から2012年9月までに，当院で施行した初回の人工股関節全置換術(THA)症例1,704関節を対象に，骨切り術既往の有無で2群に分け，その年齢分布と手術成績を比較検討した．骨切り術既往群は，骨切り術後からTHAに至るまでの期間が平均32.3年と極めて長期であったが，骨切り術既往のない群に比べTHA年齢は有意に若く，手術時間は有意に長く，最終追跡時の日本整形外科学会股関節症判定基準は有意に低かった．骨切り術が予防的手術の側面をもつことを考慮すると，骨切り術の適応はより慎重にすべきである．

　We reviewed 1,704 cases of primary total hip arthroplasty performed in our hospital between January 2008 and September 2012.　The patients were divided into a previous osteotomy group and a control group.　The average interval between the osteotomy and total hip arthroplasty in the previous osteotomy group was 32.3 years.　The average age of the patients in the previous osteotomy group at the time of the total hip arthroplasty was significantly lower, the operation time significantly longer, and the Japanese Orthopedic Association hip score significant lower than in the control group.　Since osteotomy is a surgical to procedure that is performed to prevent the need for total hip arthroplasty, the indications for osteotomy should be made stricter.