Alp Nazmi Bülent, Akdağ Gökhan, Erdoğan Fahri
Bursa Şehir Hastanesi Ortopedi ve Travmatoloji Kliniği, 16110 Doğanköy, Nilüfer, Bursa, Türkiye.
Jt Dis Relat Surg. 2020;31(2):298-305. doi: 10.5606/ehc.2020.74412. Epub 2020 Jun 18.
This study aims to report the physiological and radiological long-term results of total hip arthroplasty (THA) combined with or without subtrochanteric osteotomy in a group of developmental dysplasia of hip (DDH) patients.
This retrospective study included 90 hips of 59 patients (3 males, 56 females; mean age 45.7±10.9 years; range, 24 to 67 years) who underwent THA between January 1979 and March 2006. Thirteen patients needed subtrochanteric shortening. The evaluation was performed through Harris hip scores, physical examination, and radiological imaging.
The follow-up period ranged from 5 to 32 years, and the mean follow-up period was 10.3±6.4 years. Revision was required in 17 hips out of 90. Twelve revisions were needed because of aseptic loosening of femoral or acetabular component, three were for fracture of the femoral stem, and two for protrusio acetabuli. Four patients had transient nerve palsy, and one had permanent nerve function loss. In one patient, nonunion was observed around the femoral osteotomy site. Harris hip score was remarkably improved compared to top preoperative values (48 vs. 88.2, p<0.01).
Although revision rates tend to increase in long-term follow-up, THA is one of the best treatment options in DDH patients to relieve pain, improve daily activity levels, and minimize the damage of the knee and lumbar region.
本研究旨在报告一组发育性髋关节发育不良（DDH）患者行全髋关节置换术（THA）联合或不联合转子下截骨术的生理和放射学长期结果。
这项回顾性研究纳入了1979年1月至2006年3月期间接受THA的59例患者（3例男性，56例女性；平均年龄45.7±10.9岁；范围24至67岁）的90髋。13例患者需要转子下缩短截骨。通过Harris髋关节评分、体格检查和放射学成像进行评估。
随访期为5至32年，平均随访期为10.3±6.4年。90髋中有17髋需要翻修。12例翻修是由于股骨或髋臼组件的无菌性松动，3例是由于股骨干骨折，2例是由于髋臼内陷。4例患者出现短暂性神经麻痹，1例出现永久性神经功能丧失。1例患者在股骨截骨部位周围观察到骨不连。与术前最高值相比，Harris髋关节评分显著改善（48对88.2，p<0.01）。
尽管长期随访中翻修率有增加趋势，但THA是DDH患者缓解疼痛、提高日常活动水平并使膝关节和腰椎区域损伤最小化的最佳治疗选择之一。
