摘要
目的比较侧卧位直接前方入路(DAA)行髋关节置换术治疗大骨节病性与先天性髋臼发育不良性髋关节骨性关节炎的疗效。方法采用前瞻性研究方法,选择2015年1月至2019年12月哈尔滨医科大学附属第二医院骨四科收治的需行髋关节置换术的患者,均采用侧卧位DAA进行手术。根据纳入标准,分为大骨节病性髋关节骨性关节炎组(A组)和先天性髋臼发育不良性髋关节骨性关节炎组(B组)。在术前,术后3、14 d及1、3、12个月,进行髋关节Harris评分、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、视觉模拟量表(VAS)评分,以及髋关节外展角度、屈曲角度测量。结果A、B组分别纳入19、22例患者,所有患者均顺利完成手术。两组患者术前,术后3、14 d及1、12个月Harris评分比较,差异均无统计学意义(P均>0.05)。两组患者术前及术后各时间点WOMAC评分、VAS评分、髋关节外展角度、髋关节屈曲角度比较,差异均无统计学意义(P均>0.05)。同一组患者不同时间点Harris评分、WOMAC评分、VAS评分、髋关节外展角度、髋关节屈曲角度比较,差异均有统计学意义(P均<0.001),术后各项指标均较术前明显改善。结论侧卧位DAA行髋关节置换术治疗大骨节病性与先天性髋臼发育不良性髋关节骨性关节炎的疗效无明显差异。该手术方法对两种类型髋关节骨性关节炎均有良好的治疗效果。
Objective To compare the clinical effects of hip arthroplasty through direct anterior approach(DAA)in lateral decubitus in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia.Methods The prospective study method was used to select the patients who needed hip arthroplasty in the Fourth Department of Orthopedics,the Second Affiliated Hospital of Harbin Medical University from January 2015 to December 2019.All of them were operated with lateral decubitus DAA.According to the inclusion criteria,they were divided into Kacshin-Beck disease hip osteoarthritis group(group A)and congenital acetabular dysplasia hip osteoarthritis group(group B).Hip Harris score,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,visual analogue scale(VAS)score were conducted,and hip abduction angle and flexion angle were measured before surgery,3,14 days and 1,3,and 12 months after surgery.Results Nineteen and twenty-two patients were included in group A and group B,respectively.All patients successfully completed the surgery.There was no significant difference in Harris score between the two groups before surgery,3,14 days,and 1,12 months after surgery(P>0.05).There were no significant differences in WOMAC score,VAS score,hip abduction angle and hip flexion angle between the two groups before surgery and each time point after surgery(P>0.05).In the same group,there were significant differences in Harris score,WOMAC score,VAS score,hip abduction angle and hip flexion angle at different time points(P<0.001).All postoperative indicators were significantly improved compared with those before surgery.Conclusions There is no significant difference in the clinical effects of hip arthroplasty through lateral decubitus DAA in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia.This surgical method has good therapeutic effect on both types of hip osteoarthritis.
作者
程实
黄超
马欣楠
秦勇
李泽成
王任
于晋平
许湘宁
马英凯
梁晨
温宝柱
左忠祥
吕松岑
Cheng Shi;Huang Chao;Ma Xinnan;Qin Yong;Li Zecheng;Wang Ren;Yu Jinping;Xu Xiangning;Ma Yingkai;Liang Chen;Wen Baozhu;Zuo Zhongxiang;Lyu Songcen(The Fourth Department of Orthopedics,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China;Department of Orthopedics,Wudalianchi Hospital of Traditional Chinese Medicine,Wudalianchi 164199,China)
出处
《中华地方病学杂志》
CAS
北大核心
2022年第6期500-506,共7页
Chinese Journal of Endemiology
关键词
骨关节炎
髋
大骨节病
先天性髋臼发育不良
髋关节置换术
直接前方入路
侧卧位
Osteoarthritis,hip
Kaschin-Beck disease
Congenital acetabular dysplasia
Hip arthroplasty
Direct anterior approach
Lateral decubitus
