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全髋关节置换术与髋关节融合术治疗髋关节结核的总体疗效比较。

Comparison of total curative effect between total hip arthroplasty and hip arthrodesis in treating coxotuberculosis.

机构信息

Department of Orthopedic, The General Hospital of the PLA Rocket Force, Beijing, China.

出版信息

Eur Rev Med Pharmacol Sci. 2018 Jul;22(1 Suppl):90-95. doi: 10.26355/eurrev_201807_15369.

Abstract

OBJECTIVE

The purpose of this study was to investigate the clinical effect of total hip arthroplasty (THA) and hip arthrodesis (HA) in treating coxotuberculosis.

PATIENTS AND METHODS

40 patients with coxotuberculosis treated in the Orthopedic Department in our hospital from February 2011 to February 2016 were retrospectively analyzed. Comparison of total curative effect between THA and HA in treating coxotuberculosis was analyzed. The operation time, intraoperative blood loss, postoperative drainage volume, visual analogue scale (VAS) score, Harris hip function score (HHS), erythrocyte sedimentation rate (ESR), C reactive protein, postoperative hip pain time (PHPT), postoperative start walking time(PSWT), postoperative start weight bearing time(PSWBT) and postoperative complications were observed and compared.

RESULTS

All patients successfully underwent successful THA or HA without major complications. The operation time, intraoperative blood loss and postoperative drainage volume in patients who underwent HA were better than those of patients who underwent THA (p<0.001, p=0.010, p<0.001, respectively). During the postoperative evaluation, VAS, HHS, ESR, CRP in patients who underwent THA were better than those of patients who underwent HA, and the differences were statistically significant. About the recovery, PHPT, PSWT, PSWBT in patients who underwent THA were shorter than those in patients who underwent HA (p=0.021, p=0.044, p<0.001, respectively). There was no fracture, infection, dislocation, neurological or vascular complications in THA group. No patient had subsidence, loosening or heterotopic ossification. 1 patient in HA group had a fracture of the steel plate, and 1 patient had delayed union in HA group.

CONCLUSIONS

THA is an effective treatment for advanced tuberculous arthritis. THA is superior to HA in the treatment of coxotuberculosis.

摘要

目的

本研究旨在探讨全髋关节置换术(THA)和髋关节融合术(HA)治疗髋关节结核的临床效果。

方法

回顾性分析 2011 年 2 月至 2016 年 2 月我院骨科收治的 40 例髋关节结核患者,分析 THA 和 HA 治疗髋关节结核的总疗效。观察并比较两组手术时间、术中出血量、术后引流量、视觉模拟评分(VAS)、Harris 髋关节功能评分(HHS)、红细胞沉降率(ESR)、C 反应蛋白、术后髋关节疼痛时间(PHPT)、术后开始行走时间(PSWT)、术后开始负重时间(PSWBT)及术后并发症。

结果

所有患者均成功完成 THA 或 HA 手术,无重大并发症发生。HA 组患者的手术时间、术中出血量和术后引流量均优于 THA 组(p<0.001,p=0.010,p<0.001)。术后评估时,THA 组患者的 VAS、HHS、ESR、CRP 评分均优于 HA 组,差异有统计学意义。在恢复方面,THA 组患者的 PHPT、PSWT、PSWBT 均短于 HA 组(p=0.021,p=0.044,p<0.001)。THA 组无骨折、感染、脱位、神经血管并发症。THA 组无钢板下沉、松动或异位骨化。HA 组 1 例患者钢板骨折,1 例患者 HA 组延迟愈合。

结论

THA 是治疗晚期结核性关节炎的有效方法。THA 在治疗髋关节结核方面优于 HA。

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