Zhang Junhui, Ling Jing, Liu Hua, Tao Kun, Zeng Zhiming, Zhang Yunfeng, He Zhiyong, Di Zhenglin, Feng Jianxiang, Xu Rongming
Department of Joint Surgery, Ningbo No. 6 Hospital, Ningbo Zhejiang, 315040, P R China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Aug;27(8):990-3.
To discuss the short-term effectiveness of total hip arthroplasty (THA) for post-traumatic osteoarthritis secondary to acetabular fracture.
Between January 2004 and March 2012, the clinical data was analyzed retrospectively from 12 cases (13 hips) of post-traumatic osteoarthritis secondary to acetabular fracture undergoing THA. Of 12 patients, 6 were male and 6 were female, with an average age of 55.6 years (range, 40-68 years). The locations were the left hip in 5 cases, the right hip in 6 cases, and bilateral hips in 1 case. The interval between acetabular fracture and THA was 65.7 months on average (range, 12-240 months). The preoperative hip Harris score was 48.8 +/- 9.5.
The incisions healed by first intention. No deep vein thrombosis and infection occurred postoperatively. Ten cases were followed up 1-7 years (mean, 4.8 years). The hip Harris score was 86.5 +/- 8.6 at last follow-up, showing significant difference when compared with preoperative score (t = 10.520, P = 0.006). X-ray films showed no acetabular prosthesis instability. Stem subsidence (2 mm) occurred in 1 case, peri-prosthetic osteolysis in 2 cases, and heterotopic ossification in 2 cases (Brooker type I and type II in 1 case, respectively).
THA has satisfactory short-term effectiveness for post-traumatic osteoarthritis secondary to acetabular fracture. The good effectiveness is based on strict case selection, pathological evaluation, and the proper acetabular reconstruction.
探讨全髋关节置换术(THA)治疗髋臼骨折继发创伤性骨关节炎的短期疗效。
回顾性分析2004年1月至2012年3月间12例(13髋)髋臼骨折继发创伤性骨关节炎行THA患者的临床资料。12例患者中,男6例,女6例,平均年龄55.6岁(范围40 - 68岁)。部位:左髋5例,右髋6例,双侧髋1例。髋臼骨折至THA的间隔时间平均为65.7个月(范围12 - 240个月)。术前髋关节Harris评分为48.8±9.5。
切口一期愈合。术后未发生深静脉血栓形成及感染。10例获随访1 - 7年(平均4.8年)。末次随访时髋关节Harris评分为86.5±8.6,与术前评分比较差异有统计学意义(t = 10.520,P = 0.006)。X线片显示髋臼假体无松动。1例发生假体柄下沉(2 mm),2例发生假体周围骨溶解,2例发生异位骨化(分别为BrookerⅠ型和Ⅱ型各1例)。
THA治疗髋臼骨折继发创伤性骨关节炎具有满意的短期疗效。良好的疗效基于严格的病例选择、病理评估及合适的髋臼重建。