Zhang Xiaogang, Yang Desheng, Cao Li
Department of Orthopaedics, the First Affiliated Hospital, Xinjiang Medical University, Urumuqi Xinjiang, 830054, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Jun;22(6):649-52.
To evaluate the operative technique and the short-term clinical effect of cementless total hip arthroplasty (THA) for developmental dislocation of the hip in adults.
From December 1997 to October 2006, 61 patients (78 hips) with developmental dislocation of the hip were treated with the cementless THA. There were 8 males and 53 females with the average age of 31.4 years (ranging from 17 years to 56 years). According to the classification of Hartofilakidis, 15 cases were type I (18 hips), 23 type II (31hips), and 23 type III (29 hips). All the patients were exposed through the posterolateral approach. The threaded cup with coating was put at or near the level of the true acetabulum in all cases. Full coating stems were used in femoral sides, and shortening osteotomy below trochanter of femur was performed in 12 cases.
Sixty patients (76 hips) were followed up with the mean duration of 49 months (range 12 to 118 months). All the hips of osteotomy and bone ingrowth acquired union 3 to 14 months after the operation. No patient had radiographic evidence of aseptic loosening of prosthesis. The average leg length of the hips with femoral shortening osteotomy was lengthened 2.0 to 4.5 cm. All patients had pain relief and no obvious motion limitation, limp gait and pelvic obliquity. The Harris scores were 40.28 +/- 9.84 preoperatively and 90.92 +/- 2.80 postoperatively (P < 0.001). One patient with postoperative femoral nerve palsy completely recovered 4 months after the operation.
Cementless THA for developmental dislocation of the hip in adults produces significantly better results, although it presents great technical difficulties.
评估非骨水泥型全髋关节置换术（THA）治疗成人发育性髋关节脱位的手术技术及短期临床疗效。
1997年12月至2006年10月，采用非骨水泥型THA治疗61例（78髋）成人发育性髋关节脱位患者。其中男性8例，女性53例，平均年龄31.4岁（17岁至56岁）。根据Hartofilakidis分类，I型15例（18髋），II型23例（31髋），III型23例（29髋）。所有患者均采用后外侧入路显露。所有病例均将带涂层的螺纹髋臼杯置于真髋臼水平或其附近。股骨侧使用全涂层股骨柄，12例患者行股骨转子下缩短截骨术。
60例（76髋）获得随访，平均随访时间49个月（12至118个月）。所有截骨及骨长入的髋关节术后3至14个月均获得愈合。无患者影像学显示假体无菌性松动。行股骨缩短截骨术的髋关节平均下肢长度延长2.0至4.5厘米。所有患者疼痛均缓解，无明显活动受限、跛行步态及骨盆倾斜。术前Harris评分为40.28±9.84，术后为90.92±2.80（P<0.001）。1例患者术后出现股神经麻痹，术后4个月完全恢复。
非骨水泥型THA治疗成人发育性髋关节脱位虽技术难度大，但疗效显著更佳。
