Toni A, Bueno Lozano A L, Sudanese A, Terzi S, Calista F, Fanton F, Giunti A
Clinica Ortopedica, Università di Bologna.
Chir Organi Mov. 1994 Jul-Sep;79(3):251-63.
A total of 30 cases submitted to arthroplasty for the treatment of ankylotic hip are reported. The clinical results show that movement improved in 63% of the cases, with recovery of normal joint excursion in 37%. Severe limping consequent to hypotrophy of the gluteal musculature persisted in 62% of the cases, requiring the use of two canes in 17% of the patients. There was pain < or = 3 based on the Merle D'Aubigné and Postel evaluation scale in 13% of the patients, while 87% remained totally asymptomatic. Radiographic results were favorable: the incidence of aseptic loosening 86 months after surgery in 25 cemented prostheses was 20% for the acetabulum and 12% for the stem, while the 5 cementless prostheses were stable an average of 27 months after surgery. The incidence of aseptic loosening was greater in patients < or = 45 years of age (30% vs 10%). Early complications included dislocation (6.6%), caused by hypotrophy of the gluteal musculature secondary to the ankylosis. Leg length discrepancy, which was present preoperatively in 10 cases with an interval ranging from -5 to 6 cm (mean 3 cm), was corrected in 6 cases and reduced by half in the remaining 4 patients.
共报告了30例接受髋关节置换术治疗髋关节强直的病例。临床结果显示，63%的病例活动度得到改善，37%的病例关节活动恢复正常。62%的病例因臀肌萎缩导致严重跛行，17%的患者需要使用双拐。根据Merle D'Aubigné和Postel评估量表，13%的患者疼痛≤3级，而87%的患者完全无症状。影像学结果良好：25个骨水泥假体术后86个月无菌性松动的发生率，髋臼为20%，股骨柄为12%，而5个非骨水泥假体术后平均27个月保持稳定。年龄≤45岁的患者无菌性松动发生率更高（30%对10%）。早期并发症包括脱位（6.6%），由强直继发的臀肌萎缩引起。术前10例存在肢体长度差异，差值范围为-5至6厘米（平均3厘米），6例得到纠正，其余4例减少一半。
