Çalbıyık Murat
Department of Orthopedics and Traumatology, Hitit University, Faculty of Medicine, Corum, Turkey.
Ther Clin Risk Manag. 2018 Apr 11;14:659-664. doi: 10.2147/TCRM.S163569. eCollection 2018.
We aimed to present our experience with total hip arthroplasty in patients with previous hip arthrodesis.
This was a retrospective study, in which clinical and radiological outcomes of total hip arthroplasty performed in 17 patients (mean age 54.2±8.5 years; age range 33-68 years; female to male ratio 10/7) with previous arthrodesis in our clinic between 2001 and 2014 were reviewed. Patients were followed up for 6.7±2.8 years (range 3-12 years) after the operation and evaluated for ipsilateral knee pain, range of motion, walking capacity, and leg-length discrepancy. The clinical outcome was assessed by the Harris Hip Score.
The outcome of arthroplasty was good or excellent in 14 of 17 patients (82.3%), fair in two patients (11.8%), and failure in one patient (5.9%). The Harris Hip Score increased to 79.8±9.8 postoperatively from a preoperative score of 40.9±10.1 (<0.01). Pain-free hip was obtained in 15 patients (88.2%), and range of motion was 88°. Fourteen patients (82.4%) reported a significant decrease in back pain, and 11 patients (64.7%) in ipsilateral knee pain. Ten patients (58.8%) were able to walk normally, five patients (29.4%) walked with slight Trendelenburg gait without support, and two patients (11.8%) with severe Trendelenburg gait using arm rests. The mean leg-length discrepancy was 1.1 cm (range 0-3 cm). The complications were peroneal nerve palsy (n=3), superficial wound infection (n=3), hip dislocation (n=2), and heterotopic ossification (n=3).
If it is well planned, conversion of hip arthrodesis to total hip arthroplasty is a successful and safe procedure, which increases patients' functionality.
我们旨在介绍我们在既往髋关节融合患者中进行全髋关节置换术的经验。
这是一项回顾性研究,回顾了2001年至2014年间在我们诊所对17例(平均年龄54.2±8.5岁;年龄范围33 - 68岁;男女比例为10/7)既往有髋关节融合的患者进行全髋关节置换术的临床和放射学结果。术后对患者进行了6.7±2.8年(范围3 - 12年)的随访,并评估同侧膝关节疼痛、活动范围、行走能力和肢体长度差异。临床结果通过Harris髋关节评分进行评估。
17例患者中,14例(82.3%)的关节置换术结果为良好或优秀,2例(11.8%)为中等,1例(5.9%)为失败。Harris髋关节评分从术前的40.9±10.1分提高到术后的79.8±9.8分(<0.01)。15例(88.2%)患者获得无痛髋关节,活动范围为88°。14例(82.4%)患者报告背痛显著减轻,11例(64.7%)患者同侧膝关节疼痛减轻。10例(58.8%)患者能够正常行走,5例(29.4%)患者在无支撑的情况下行走时有轻微的Trendelenburg步态,2例(11.8%)患者在使用扶手的情况下有严重的Trendelenburg步态。平均肢体长度差异为1.1 cm(范围0 - 3 cm)。并发症包括腓总神经麻痹(n = 3)、浅表伤口感染(n = 3)、髋关节脱位(n = 2)和异位骨化(n = 3)。
如果计划得当,将髋关节融合转换为全髋关节置换术是一种成功且安全的手术,可提高患者的功能。