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采用模块化全髋关节置换术治疗重度髋内翻继发的骨关节炎。

Treatment of Osteoarthritis Secondary to Severe Coxa Vara with Modular Total Hip Arthroplasty.

作者信息

Zhang Bohan, Sun Jingyang, Du Yinqiao, Shen Junmin, Li Tiejian, Zhou Yonggang

机构信息

Medical School of Chinese PLA, Beijing, 100853, People's Republic of China.

Department of Orthopedics, The First Medical Center of PLA General Hospital, Beijing, 100853, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2021 Nov 19;17:1199-1207. doi: 10.2147/TCRM.S335015. eCollection 2021.

DOI:10.2147/TCRM.S335015
PMID:34824533
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8610750/
Abstract

OBJECTIVE

We aimed to demonstrate the methods of treatment for coxa vara with modular total hip arthroplasty (THA) and evaluate clinical and radiographic outcomes, and further survivorship at the midterm follow-up.

METHODS

We retrospectively reviewed 33 patients (42 hips) who underwent modular THA for coxa vara deformity from May 2008 to December 2019. The clinical and radiographic results, including Harris Hip Score (HHS), leg length discrepancy (LLD), greater trochanteric height, femoral offset, abductor lever arm, stem alignment and limp, and complications, were evaluated.

RESULTS

The follow-up time was mean 69.9±43.7 months. Clinically, the HHS improved significantly (p<0.001) on average from 42.90±14.44 points to 89.54±4.75 points. The mean LLD decreased from 33.3±19.4 mm to 5.0±5.8 mm (p<0.001), and 27 patients (82%) thought that total equality of the lower limbs was obtained. Patients demonstrated diminished or no limping in 88% (29/33) of hips and a significant improvement of biomechanics. At the final follow-up, all stems of hips were in clinical neutral alignment and the prostheses survivorship rates for all-causes revisions was 97.6%.

CONCLUSION

Modular THA is a valuable alternative to render favorable outcomes for treatment of osteoarthritis secondary to severe coxa vara.

摘要

目的

我们旨在展示采用模块化全髋关节置换术（THA）治疗髋内翻的方法，并评估临床和影像学结果，以及中期随访时的进一步生存率。

方法

我们回顾性分析了2008年5月至2019年12月期间因髋内翻畸形接受模块化THA的33例患者（42髋）。评估了临床和影像学结果，包括Harris髋关节评分（HHS）、下肢长度差异（LLD）、大转子高度、股骨偏移、外展肌杠杆臂、假体柄对线和跛行情况以及并发症。

结果

随访时间平均为69.9±43.7个月。临床上，HHS平均从42.90±14.44分显著提高至89.54±4.75分（p<0.001）。平均LLD从33.3±19.4mm降至5.0±5.8mm（p<0.001），27例患者（82%）认为下肢完全等长。88%（29/33）的髋关节患者跛行减轻或消失，生物力学有显著改善。在末次随访时，所有髋关节的假体柄均处于临床中立对线，全因翻修的假体生存率为97.6%。

结论

模块化THA是治疗重度髋内翻继发骨关节炎的一种有价值的替代方法，可带来良好的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/eccbe7b73da0/TCRM-17-1199-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/19625e3c565f/TCRM-17-1199-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/73c3538f31c1/TCRM-17-1199-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/5fd2df9e3b9c/TCRM-17-1199-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/a79d91df0bed/TCRM-17-1199-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/eccbe7b73da0/TCRM-17-1199-g0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/19625e3c565f/TCRM-17-1199-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/73c3538f31c1/TCRM-17-1199-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/5fd2df9e3b9c/TCRM-17-1199-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/a79d91df0bed/TCRM-17-1199-g0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ade7/8610750/eccbe7b73da0/TCRM-17-1199-g0005.jpg

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