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一名软骨发育不全患者的双侧全髋关节置换术:挑战与手术策略

Bilateral Total Hip Arthroplasty in a Patient With Achondroplasia: Challenges and Surgical Strategies.

作者信息

Jeremic Danilo, Ostojic Jelena Nesovic, Krivokapic Branislav, Bascarevic Zoran, Zarkovic Nikola, Slavkovic Nemanja

机构信息

Institute for Orthopedics Banjica, Belgrade, Serbia.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

Arthroplast Today. 2025 Mar 3;32:101654. doi: 10.1016/j.artd.2025.101654. eCollection 2025 Apr.

Abstract

This case report provides a history of a female patient with achondroplasia who underwent bilateral total hip arthroplasty (THA) using short femoral stem. On preoperative radiography, a severe bilateral hip osteoarthritis was noted, with deformity of the femoral metaphyses. After THA, the gait pattern improved significantly, the range of motion of both hips increased, and limb length discrepancy was corrected. There was also an improvement in Harris Hip Score value from 65 to 87. In patients with achondroplasia who develop end-stage hip osteoarthritis, there is a unique challenge for arthroplasty surgeons, including implant design, sizing, positioning, and soft-tissue balancing. We believe that the use of short femoral stems might represent an acceptable surgical strategy in the setting of complex changes in femoral anatomy.

摘要

本病例报告介绍了一名患有软骨发育不全的女性患者的病史,该患者接受了使用短股骨干的双侧全髋关节置换术(THA)。术前X线检查显示双侧严重髋骨关节炎,伴有股骨干骺端畸形。全髋关节置换术后,步态模式明显改善,双髋关节活动范围增加,肢体长度差异得到纠正。Harris髋关节评分也从65分提高到了87分。对于患有终末期髋骨关节炎的软骨发育不全患者,关节置换外科医生面临着独特的挑战,包括植入物设计、尺寸确定、定位和软组织平衡。我们认为,在股骨解剖结构发生复杂变化的情况下,使用短股骨干可能是一种可接受的手术策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4aa/11925087/74d53e140e33/gr1.jpg

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