Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, China.
Orthop Surg. 2020 Dec;12(6):1913-1922. doi: 10.1111/os.12843. Epub 2020 Nov 13.
The aim of the present paper was to evaluate the results of one-stage total hip arthroplasty (THA) for patients with bilateral Crowe type IV developmental dysplasia of the hip (DDH).
Data for 58 patients (116 hips) with bilateral Crowe type IV DDH who had one-stage THA performed by the same surgeon during the period of April 2008 to February 2019 were retrospectively reviewed. The mean age of the patients was 37.3 years; 5 were men and 53 were women. All patients underwent THA through the posterolateral approach using the Pinnacle acetabular cup, a ceramic-on-ceramic bearing, and the modular S-ROM stem. Subtrochanteric shortening osteotomy was performed on 86/116 hips. Intraoperative conditions were recorded. Radiographic and functional outcomes were evaluated, and complications were recorded.
All patients were followed up for an average of 71.3 ± 37.6 months (range, 12-140). The mean operative time was 276.5 ± 57.9 min (range, 175-540). The mean intraoperative blood loss was 933.6 ± 400.8 mL (range, 300-2000). The mean transfusion requirement was 1778 ± 798.0 mL (range, 575-4550). The mean length of hospital stay was 8.6 ± 3.7 days (range, 5-22). At the final follow-up, no loosening of acetabular and femoral components was observed. No osteolysis and heterotopic ossification occurred. The mean Harris hip scores were improved from 55.4 ± 14.3 preoperatively to 91.3 ± 4.2 postoperatively (P < 0.001) In terms of complications, no perioperative deaths were recorded. Deep vein thrombosis occurred in 1 hip, with no pulmonary embolism. Intraoperative femur fracture occurred in 3 hips, nerve injury in 1 hip, and leg length discrepancy in 1 patient. Postoperative dislocation occurred in 5 hips and nonunion in 1 hip.
Our data demonstrated that one-stage bilateral THA for bilateral Crowe type IV DDH is feasible and can effectively restore hip function.
本研究旨在评估同期双侧全髋关节置换术（THA）治疗双侧 Crowe Ⅳ型发育性髋关节发育不良（DDH）患者的临床疗效。
回顾性分析 2008 年 4 月至 2019 年 2 月期间由同一位外科医生行同期双侧 THA 的 58 例（116 髋）双侧 Crowe Ⅳ型 DDH 患者的临床资料。患者的平均年龄为 37.3 岁（范围：18-54 岁）；其中男性 5 例，女性 53 例。所有患者均采用后外侧入路，使用 Pinnacle 髋臼杯、陶瓷对陶瓷关节、模块化 S-ROM 股骨柄。86/116 髋行转子下短缩截骨术。记录术中情况。评估影像学和功能结果，并记录并发症。
所有患者均获得平均 71.3±37.6 个月（范围：12-140 个月）的随访。平均手术时间为 276.5±57.9 分钟（范围：175-540 分钟）。平均术中失血量为 933.6±400.8ml（范围：300-2000ml）。平均输血需求为 1778±798.0ml（范围：575-4550ml）。平均住院时间为 8.6±3.7 天（范围：5-22 天）。末次随访时，髋臼和股骨假体均未出现松动。无骨溶解和异位骨化发生。Harris 髋关节评分由术前的 55.4±14.3 分提高至术后的 91.3±4.2 分（P<0.001）。并发症方面，无围手术期死亡病例。1 髋发生深静脉血栓，无肺栓塞。3 髋术中发生股骨骨折，1 髋发生神经损伤，1 例肢体长度不等长。术后发生 5 髋脱位，1 髋骨不连。
同期双侧 THA 治疗双侧 Crowe Ⅳ型 DDH 是可行的，可有效恢复髋关节功能。
