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[针对髋关节发育不良继发终末期骨关节炎患者的全髋关节置换术]

[Total hip replacement for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip].

作者信息

Hu Yihe, Zhou Tianjian, Liu Hua, Li Kanghua, Lei Guanghua

机构信息

Department of Orthopaedic Surgery, Central South University, Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2009 Nov;34(11):1142-7.

PMID:19952406
Abstract

OBJECTIVE

To investigate the surgical techniques and clinical outcomes of total hip replacement for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip.

METHODS

From May 2004 to March 2008, a total of 36 total hip replacements were performed in 32 patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip. The acetabulum cup was reconstructed in the corresponding anatomical position in all cases. Cemented components were used in 16 hips, and cementless components in the other 20 hips. The mean follow-up was 31.3 months. Clinical outcomes were determined with Harris hip score. Radiographs were taken after the surgery and in every follow-up examination for further reference.

RESULTS

All patients postoperatively gained a limb lengthening with an average of (3.4+/-1.3) cm. Three patients had complications, 2 had nondisplaced fractures of the proximal part of the femur,and 1 sciatic nerve palsy which disappeared after 3 months. There was no infection, dislocation and symptomatic deep vein thrombosis. Compared with preoperation, the mean Harris hip scores on the 3rd day, the 14th day after the operation and at the last follow-up were all improved significantly (all P<0.05). There was no loosening, migration, heterotopic ossification radiographically, and no revision during the follow-up.

CONCLUSION

Total hip replacement is an effective treatment for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip. The key is to place the acetabulum cup in the corresponding anatomical position, and choose proper prosthesises during the surgery.

摘要

目的

探讨髋关节发育不良继发终末期骨关节炎患者全髋关节置换的手术技术及临床疗效。

方法

2004年5月至2008年3月,对32例髋关节发育不良继发终末期骨关节炎患者行全髋关节置换术,共36髋。所有病例均在相应解剖位置重建髋臼杯。16髋采用骨水泥型假体,另外20髋采用非骨水泥型假体。平均随访31.3个月。采用Harris髋关节评分评估临床疗效。术后及每次随访时均拍摄X线片以供进一步参考。

结果

所有患者术后均有肢体延长,平均延长(3.4±1.3)cm。3例患者出现并发症,2例股骨近端无移位骨折,1例坐骨神经麻痹,3个月后消失。无感染、脱位及有症状的深静脉血栓形成。与术前相比,术后第3天、第14天及末次随访时Harris髋关节平均评分均显著提高(均P<0.05)。影像学检查无松动、移位、异位骨化,随访期间无翻修病例。

结论

全髋关节置换是治疗髋关节发育不良继发终末期骨关节炎患者的有效方法。关键是将髋臼杯置于相应解剖位置,并在手术中选择合适的假体。

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