Sonekatsu Mayumi, Sonohata Motoki, Kitajima Masaru, Kawano Shunsuke, Mawatari Masaaki
Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga 849-8501, Japan.
Acta Med Okayama. 2018 Apr;72(2):203-210. doi: 10.18926/AMO/55864.
In patients with poliomyelitis, degenerative arthritis of the hip may be encountered in the paralytic or normal contralateral limb because of leg length discrepancy, pelvic obliquity, or severe deformities of the affected hip. Although total hip arthroplasty (THA) is one of the most common orthopedic procedures, there are few reports of THA in adult patients with residual poliomyelitis. From March 2001 to January 2011, 5 patients with residual poliomyelitis (6 hips) underwent THA using uncemented implants at our hospital. We retrospectively evaluated the Japanese Orthopaedic Association (JOA) hip score, complications, and radiographs. All five patients' follow-up information was available: 4.5 years minimum, 8.4 years average, range 4.5-15 years. Surgery was done at the same side of the paralytic limb in 2 hips and contralateral to the paralytic limb in four hips. All patients had pain relief and improvement in function; JOA hip score improved significantly from the mean of 42.8 preoperatively to 78.8 at the last follow-up (p=0.028). There was no loosening or osteolysis in this series, and no cases of dislocation, infection or nerve palsy. These findings can contribute to decisions regarding treatment for arthritic hips in adults with residual poliomyelitis.
在小儿麻痹症患者中，由于腿长差异、骨盆倾斜或患侧髋关节严重畸形，麻痹侧或正常对侧肢体可能会出现髋关节退行性关节炎。尽管全髋关节置换术（THA）是最常见的骨科手术之一，但关于成年残留小儿麻痹症患者接受THA的报道却很少。2001年3月至2011年1月，我院有5例残留小儿麻痹症患者（6髋）接受了使用非骨水泥假体的THA手术。我们回顾性评估了日本骨科协会（JOA）髋关节评分、并发症及X线片情况。所有5例患者均有随访资料：最短4.5年，平均8.4年，范围4.5 - 15年。2髋手术在麻痹侧肢体同侧进行，4髋在麻痹侧肢体对侧进行。所有患者疼痛均缓解，功能改善；JOA髋关节评分从术前平均42.8显著提高至末次随访时的78.8（p = 0.028）。本系列中无假体松动或骨溶解情况，也无脱位、感染或神经麻痹病例。这些结果有助于为成年残留小儿麻痹症患者的关节炎性髋关节治疗决策提供参考。
