Kumar M N, Swann M
Department of Orthopaedics, Wexham Park Hospital, Slough.
Ann R Coll Surg Engl. 1998 May;80(3):203-9.
The hip joint is commonly affected in juvenile chronic arthritis (JCA) and involvement is usually bilateral. It is well established that the involvement of the hip in JCA is the most important reason that the patient will lose independence and mobility. The positive gains, both in terms of hip function and the overall functional capability, of the patients of JCA after hip replacement have been shown by several studies. There have been many reports regarding cemented total hip replacement in young patients with JCA. The short-term results have been excellent, but failure rates were considerably higher with further follow-up. To our knowledge there have been no other reports to date of the results of cementless arthroplasty of the hip in this condition. We reviewed the results of 25 primary uncemented total hip replacements (THR) in 16 patients with JCA. The mean postoperative follow-up time was 4.5 years (range 1-19 years). The clinical results were evaluated using the modified Harris hip score. The functional outcome was assessed by a scoring system described by Witt et al. The most significant long-term problem was acetabular loosening (12%) in our series.
髋关节在青少年慢性关节炎(JCA)中常受累,且通常为双侧受累。众所周知,JCA累及髋关节是患者失去独立能力和活动能力的最重要原因。多项研究表明,JCA患者行髋关节置换术后,在髋关节功能和整体功能能力方面均有积极改善。关于年轻JCA患者行骨水泥型全髋关节置换术已有许多报道。短期效果极佳,但进一步随访发现失败率相当高。据我们所知,迄今为止尚无关于这种情况下非骨水泥型髋关节置换术结果的其他报道。我们回顾了16例JCA患者行25例初次非骨水泥型全髋关节置换术(THR)的结果。术后平均随访时间为4.5年(范围1 - 19年)。采用改良Harris髋关节评分评估临床结果。功能结局通过Witt等人描述的评分系统进行评估。在我们的系列研究中,最显著的长期问题是髋臼松动(12%)。