Chen Xian-Jun, Liu Bing-Gen, Pang Qing-Jiang, Yu Xiao
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China.
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China;
Zhongguo Gu Shang. 2016 Aug 25;29(8):718-722. doi: 10.3969/j.issn.1003-0034.2016.08.009.
To evaluate the short term clinical effects and surgery methods of the total hip arthroplasty (THA)for the treatment of Crowe type IV congenital dysplasia of hip (CDH) in adults.
From March 2013 to March 2015, 20 patients (20 hips) with Crowe type IV CDH in adults were underwent THA, including 4 males and 16 females, with an average age of 52 years old ranged from 32 to 68 years old. All the cementless acetabular cups were placed at the original anatomic location. S-ROM prosthesis was adopted together with subtrochanteric transverse osteotomy in femoral side. All the patients were evaluated by using the Modified Harris Hip Score. Radiographic evaluations were made preoperatively and during follow up.
The incisions were healed by first intention. There was no hip dislocation events and venous thrombosis occurred. All patients were followed up for 8 to 60 months with an average of 38.1 months. Postoperative X ray films showed all acetabular prosthesis were in true acetabulum. No nonunion and loosening were found in all patients. Harris score at final follow up improved from preoperative 50.90±9.35 to postoperative 90.25±3.16. The difference was statistically significant (<0.05). There were 1 patient with femoral split fracture, 1 patient with nerve injury, 1 patient with heterotopic ossification of Brooker I. The hip function of all patients was good, the pain was disappeared.
THA with S-ROM prosthesis and subtrochanteric osteotomy is an effective method for the treatment of Crowe type IV CDH in adults. The recent clinical curative effect is satisfied.
评估全髋关节置换术(THA)治疗成人Crowe Ⅳ型先天性髋关节发育不良(CDH)的短期临床效果及手术方法。
2013年3月至2015年3月,对20例(20髋)成人Crowe Ⅳ型CDH患者行THA,其中男性4例,女性16例,平均年龄52岁,年龄范围32~68岁。所有非骨水泥髋臼杯均置于原解剖位置。股骨侧采用S-ROM假体并加转子下横行截骨。所有患者均采用改良Harris髋关节评分进行评估。术前及随访期间进行影像学评估。
切口均一期愈合。未发生髋关节脱位及静脉血栓形成。所有患者随访8~60个月,平均38.1个月。术后X线片显示所有髋臼假体均位于真臼内。所有患者均未发现骨不连及松动。末次随访时Harris评分由术前的50.90±9.35提高至术后的90.25±3.16。差异有统计学意义(<0.05)。发生1例股骨劈裂骨折、1例神经损伤、1例Brooker Ⅰ型异位骨化。所有患者髋关节功能良好,疼痛消失。
采用S-ROM假体及转子下截骨的THA是治疗成人Crowe Ⅳ型CDH的有效方法。近期临床疗效满意。