Wang Qi, Zhang Xian-long, Jiang Yao, Chen Yun-su, Shen Hao, Shao Jun-jie
Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China.
Zhonghua Wai Ke Za Zhi. 2008 Sep 1;46(17):1293-6.
To study the clinical results of metal on metal hip resurfacing arthroplasty for developmental dysplasia patients.
From March 2005 to December 2006, 34 cases of developmental dysplasia patients (Crowe I, Crowe II) were attempted to have metal on metal hip resurfacing arthroplasty. There were 29 females (32 hips), 5 males (5 hips). The average age was 45 (26 - 57) years old. Radiographic and clinical evaluations were taken at 6 weeks, 3 months, 1 year and then once a year postoperatively. The average Harris score was 35 (25 - 44). Hip flexion was 101 degrees , abduction 24 degrees , adduction 15 degrees .
Three patients were turned to total hip arthroplasty during operations. Thirty-one patients (34 hips) received hip resurfacing surgery. These 31 patients were followed for average 21.4 months (12 - 33 months). The average Harris score was 94 (82 - 100) at the latest follow-up, and there was statistical difference compared with the preoperative score (P < 0.01). Hip flexion increased to 133 degrees , abduction to 48 degrees , adduction to 26 degrees . No radiolucency line was found at both acetabular and femoral sides in all the patients. The average abduction angle of acetabular cup was 43 degrees (40 degrees - 53 degrees ), and the average stem shaft angle was 139 degrees (130 degrees - 145 degrees ).
The short term result is excellent. While the mid to long term results for hip resurfacing arthroplasty in developmental dysplasia patients are still looking forward, and the meticulous surgical technique and strict patient selection are the key of the good results.
研究金属对金属髋关节表面置换术治疗发育性髋关节发育不良患者的临床效果。
2005年3月至2006年12月,对34例发育性髋关节发育不良患者(Crowe I型、Crowe II型)尝试行金属对金属髋关节表面置换术。其中女性29例(32髋),男性5例(5髋)。平均年龄45岁(26 - 57岁)。术后6周、3个月、1年及之后每年进行影像学和临床评估。平均Harris评分为35分(25 - 44分)。髋关节屈曲101度,外展24度,内收15度。
3例患者术中转为全髋关节置换术。31例患者(34髋)接受了髋关节表面置换手术。这31例患者平均随访21.4个月(12 - 33个月)。末次随访时平均Harris评分为94分(82 - 100分),与术前评分相比有统计学差异(P < 0.01)。髋关节屈曲增加到133度,外展到48度,内收增加到26度。所有患者髋臼和股骨侧均未发现透亮线。髋臼杯平均外展角为43度(40度 - 53度),柄干平均角为139度(130度 - 145度)。
短期效果良好。发育性髋关节发育不良患者髋关节表面置换术的中长期效果仍有待观察,精细的手术技术和严格的患者选择是取得良好效果的关键。