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[类风湿性髋关节及其矫形外科治疗]

[Rheumatoid hip joint and its orthopedic surgical treatment].

作者信息

Schwägerl W

出版信息

Orthopade. 1986 Aug;15(4):330-4.

PMID:3763223
Abstract

In the early stage of the disease, synovectomy of the hip seems to be a successful technique, but the timing of the operation is difficult because of interference with conservation treatment. Osteotomy in rheumatoid arthritis of the hip is not very successful; arthrodesis is not recommended. In the late stage of the disease the treatment of choice is joint replacement. Here osteoporosis and the protrusion of the acetabulum present more technical problems than in other hip diseases. Implants with various designs and various implantation techniques with or without bone cement are used. The use of bone grafts, especially for protrusion, represents real progress, and there is a trend toward using cementless implantation, especially for young patients. Failures are due to difficulties in morphology, but there are no more reoperations than in osteoarthritis, and mortality seems to be higher than in osteoarthritis.

摘要

在疾病早期,髋关节滑膜切除术似乎是一种成功的技术,但由于会干扰保守治疗,手术时机很难把握。髋关节类风湿关节炎的截骨术不太成功;不建议进行关节融合术。在疾病晚期,首选的治疗方法是关节置换。与其他髋关节疾病相比,这里的骨质疏松和髋臼突出带来了更多技术问题。使用了各种设计的植入物以及有无骨水泥的各种植入技术。骨移植的使用,尤其是针对髋臼突出的情况,代表了真正的进步,并且有一种趋势是使用非骨水泥植入,特别是对于年轻患者。失败是由于形态学方面的困难,但再次手术的情况并不比骨关节炎更多,而且死亡率似乎高于骨关节炎。

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