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[改良髋臼中心化技术对全髋关节置换术中肢体长度不等的影响]

[Effect of reformative acetabular centralization technology on leg-length inequality in total hip arthroplasty].

作者信息

Cao Linhu, Tan Lun, Wu Chao, Lin Xu, Guo Yong, Luo Xiaozhong, Liu Shiwei

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Feb;28(2):213-7.

Abstract

OBJECTIVE

To investigate the application value of acetabular centralization technology for correction of leg-length inequality in total hip arthroplasty (THA).

METHODS

Between June 2001 and January 2012, 147 cases of abnormal acetabular center were treated. Of them, 68 cases underwent routine THA (control group), and 79 cases underwent acetabular reconstruction by fossae ovalis oriented centralized technology in THA (test group). There was no significant difference in gender, age, side, pathogeny, acetabular rotation center indexs, difference of relative and absolute leg-length, and Harris score between 2 groups before operation (P > 0.05). The hip joint function was evaluated by Harris score; the difference of relative leg-length was measured by tape; the difference of absolute leg-length and the horizontal and vertical distances of actual and true rotation center were also measured on the X-ray films by software.

RESULTS

The patients were followed up 8-26 months (mean, 8.3 months) in the test group, and 6-33 months (mean, 9.7 months) in the control group. Sciatic nerve injury occurred in 2 cases (1 in each group, respectively), lower extremity deep venous thrombosis in 7 cases (3 in test group and 4 in control group), and hip joint dislocation in 2 cases (control group); the other patients had no related complications. The difference of relative leg-length and Harris score in test group were significantly better than in control group (P < 0.05), and significant difference was also found when compared with preoperative one in 2 groups (P < 0.05). The horizontal and vertical distances of actual and the true rotation center in test group was significantly better than those in control group at immediate after operation on the X-ray films (P < 0.05); and significant differences were also found when compared with preoperative ones in 2 groups (P < 0.05). At 6 months after operation, the absolute leg-length difference in test group was significantly better than that in control group (P < 0.05); and significant difference was also found when compared with preoperative one in 2 groups (P < 0.05).

CONCLUSION

The fossae ovalis oriented acetabular centralized technology in THA can significantly correct abnormal hip center of rotation, thus reduce the relative and absolute leg-length inequality and improve the life quality of the patients.

摘要

目的

探讨髋臼中心化技术在全髋关节置换术(THA)中矫正肢体长度不等的应用价值。

方法

2001年6月至2012年1月,治疗髋臼中心异常患者147例。其中,68例行常规THA(对照组),79例行髋臼重建的THA,采用以卵圆窝为导向的中心化技术(试验组)。两组患者术前在性别、年龄、患侧、病因、髋臼旋转中心指数、相对与绝对肢体长度差及Harris评分方面差异均无统计学意义(P>0.05)。采用Harris评分评估髋关节功能;用卷尺测量相对肢体长度差;通过软件在X线片上测量绝对肢体长度差以及实际与真旋转中心的水平和垂直距离。

结果

试验组患者随访8 - 26个月(平均8.3个月),对照组随访6 - 33个月(平均9.7个月)。两组各有1例发生坐骨神经损伤;试验组3例、对照组4例发生下肢深静脉血栓;对照组发生2例髋关节脱位;其他患者无相关并发症。试验组相对肢体长度差及Harris评分均显著优于对照组(P<0.05),两组与术前相比差异也有统计学意义(P<0.05)。术后即刻X线片显示试验组实际与真旋转中心的水平和垂直距离显著优于对照组(P<0.05);两组与术前相比差异也有统计学意义(P<0.05)。术后6个月,试验组绝对肢体长度差显著优于对照组(P<0.05);两组与术前相比差异也有统计学意义(P<0.05)。

结论

THA中以卵圆窝为导向的髋臼中心化技术可显著矫正异常髋关节旋转中心,从而减少相对和绝对肢体长度不等,提高患者生活质量。

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