摘要
[目的]评价生物型假体全髋关节置换术(total hip arthroplasty,THA)治疗成人髋关节发育不良(develop-mental dysplasia of hip,DDH)继发骨关节炎的疗效。[方法]对2002年2月～2009年8月在本院行THA治疗的76例(102髋)髋关节发育不良继发骨关节炎患者的临床及影响学资料进行回顾性分析,其中男34例,女42例;年龄35～64岁,平均52.5岁。用Harris髋关节评分系统评价手术的临床疗效。根据骨盆平片及患髋正、侧位X线片观察髋臼、股骨假体的位置及其周围骨质变化。[结果]所有患者均获2年以上随访,平均5.3年。术后4例仍有轻度疼痛,服用非甾体类止痛药后缓解。8例存在不同程度下肢不等长(0.5～1.2 cm),Trendelenburg征阴性,无跛行。末次随访时Harris评分平均值(89.5±3.8)分,优46例(60髋),良20例(30髋),可10例(12髋);优良率为88.2%。末次随访时髋臼假体位置无明显移位,头臼包容性良好。30例出现异位骨化,6例出现髋臼周围骨溶解。股骨柄假体的位置无明显改变,中心固定有98髋(94.1%),柄-髓腔匹配优良率100%。4髋出现股骨侧骨溶解,8髋假体柄与股骨界面出现透亮线。所有病例均出现股骨近端骨重塑,其中I度92髋,Ⅱ度10髋。无感染、假体松动、假体周围骨折等并发症发生。[结论]生物型假体全髋关节置换术治疗成人髋关节发育不良继发骨关节炎的疗效满意。
[ Objective ] To evaluate the effect of total hip arthroplasty using a cementless prosthesis in treating osteoarthritis secondary to developmental dysp^asia of the hip in adult. [Methods] Data of 76 patients （102 hips） , who had undergone total hip arthroplasty for osteoarthritis secondary to developmental dysplasia of the hip from February 2002 to August 2009, were retrospectively analyzed. There were 34 males and 42 females, aged from 35 to 64 years （ average, 52. 5 years） . Harris hip score was used to assess the clinical efficacy. The components migration and periprosthetic bone changes were measured according to pelvic plain films and X - rays of the hip. Postoperative complications were recorded. [ Results ] Seventy - six patients were followed up for more than 2 years （ average, 5.3 years） . Four patients suffered from mild pain which could be alleviated after taking non - steroidal analgesics. The inequality of lower extremity occurred in 8 patients, ranged from 0. 5 to 1.2 cm, while Trendelenburg sign and cripple happened in none of our cases. According to the Harris hip score, the excellent and good results rate was 88.2%. During our follow - up, no obvious migration of the acetabular and femoral prosthesis happened. Heter- otopic ossification occurred in 30 cases. Osteolysis around the acetabular prosthesis appeared in 6 eases. Femoral prosthesis stems matched the medullary canal pretty well. Bone remolding was found in the proximal femoral in all patients. No hip infection, prosthesis loosening as well as periprosthetie fracture happened during our study. [ Conclusion] The outcome of THA u- sing a cementless prosthesis in treating osteoarthritis secondary to DDH is satisfactory.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2013年第15期1502-1507,共6页
Orthopedic Journal of China
关键词
髋关节发育不良
骨性关节炎
全髋关节置换术
生物型假体
developmental dysplasia of the hip, osteoarthritis, total hip arthroplasty, cementless prosthesis
