著者

古賀 敬 内藤 正俊 秋吉 祐一郎 白水 圭 浅山 勲 Tatsunobu Abe

出版者

West-Japanese Society of Orthopedics & Traumatology

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.51, no.1, pp.148-152, 2002-03-25 (Released:2010-02-25)

参考文献数

12

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Sciatic nerve palsy is a proble troublesome complication of total hip arthroplasty. It may be caused by direct injury or over-traction at the time of operation. We investigated the effects of the hip and knee positions on the blood flow of the sciatic nerve of dogs. Tweyty hip joints of 10 adult mongrel dogs were examined.The blood flow in the sciatic nerve was measured using a Laser Doppler Flowmetry, at varying angles of flexion (90°, 120°, 150°) and internal rotation (0°, 30°) of the hip joint and angles of flexion of the knee (0°, 30°, 60°, 90°). This study showed that the blood flow in the sciatic nerve decreases with increasing flexion angle and increasing internal rotation angle of the hip joint, and that decreases in the flexion angle of the knee joint result in especially pronounced decreases in blood flow. We consider that the position of the hip and knee positions are considered a significant risk factor in total hip arthroplasty parformed with over-lengthening. Our results suggest that surgeons should pay attention to knee extension and the flexion and internal rotation positions of the hip tp prevent sciatic nerve palsy as a complication of total hip arthroplasty.

著者

石河 利之 内藤 正俊 浅山 勲 山口 哲 秋吉 祐一郎 藤澤 基之 神戸 太一 安部 龍暢 白水 圭 舌間 崇士

出版者

West-Japanese Society of Orthopedics & Traumatology

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.52, no.1, pp.5-9, 2003-03-25

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The purpose of the present study is to report the mid-term results of modified Sugioka transtrochanteric valgus ostetomy (TVO) for the treatment of secondary osteoarthritis. The lateral displacement of the greater trochanter was simultaneously performed. Fourteen TVOs were performed in 14 patients with unilateral osteoarthritis of the hip from 1993. We assessed 8 hips in 8 patients in this study. The mean age of the patients at the time of surgery was 46.4 years (41 to 55 years). The average follow-up was 3.9 years (2.4-7.2years). The patients were evaluated for radiographic changes of the joint space, roof osteophyte, weight bearing surface of acetabulum, AHI, abductor lever arm, capital drop, bone cyst in the acetabulum or femoral head as well as clinical results using JOA score. The mean JOA score improved from 57.4 to 76.3. The widening of joint space, lengthening of weight bearing surface of acetabulum were seen in seven hips. The length of the abductor lever arm after surgery was not proportional to the JOA score at the latest follow-up. In one patient, total hip arthroplasty was required after 2.2 years. This procedure is considered useful for the treatment of osteoarthritis in dysplastic hips.