全髋关节置换治疗髋关节创伤性骨关节炎  

Total Hip Joint Replacement in the Treatment of Traumatic Osteoarthritis of Hip

作　　者：杨效宁[1] 杨静[1] 沈彬[1] 刘雷[1] 裴福兴[1] 

机构地区：[1]四川大学华西医院骨科,四川成都610041

出　　处：《华西医学》2005年第2期223-225,共3页West China Medical Journal

摘　　要：目的:探讨人工全髋关节置换术治疗临床常见的髋关节创伤性骨关节炎的方法和疗效。方法:本组共收治髋关节创伤性骨关节炎患者44例44髋,男28例,女16例,平均年龄55.6岁。髋部受伤时诊断:髋臼骨折14例,其中6例合并股骨头脱位;股骨颈骨折21例;单纯髋关节脱位1例;另外8例有髋部外伤史,但未发现髋关节骨折或脱位。术前Harris评分平均为49.9分。本组患者全部行人工全髋关节置换术治疗。髋臼侧38例采用非骨水泥假体,6例骨水泥假体;股骨侧采用非骨水泥假体15例,骨水泥29例。结果:术后切口均一期愈合,随访6个月～5年,Harris评分平均为93.4分,X线片未见假体周围骨溶解;无感染,无翻修。显示该组病例均取得了良好的临床疗效,髋关节功能得到明显改善。结论:随着关节外科技术、假体材料及设计的不断改进,全髋关节置换术是治疗创伤性骨关节炎的有效方法。较一般退变性骨关节炎比较其手术难度大,术前要充分考虑到创伤引起的髋臼及股骨的继发病理改变,以便在术中采取相应的措施。Objective:TO discuss the replacement method and its outcome in the treatment of fraumatic osteoarthritis of hip.Methods:Fourty-four patients (44 hips) were studied,mean aged of 55.6 and male 28 and female 16.The diagnosis included acetabular fracture 14 cases,in which 6 cases were concomitant with hip dislocation; femoral neck fracture 21 cases;Simple hip dislocation 1 case and 8 patients had trauma of the hip but withou definite evidence of fracture or dislocation.The mean preoperative Harris score was 49.9.All the patients in this group were treated by total hip replacement.Thirty-eight cementless prostheses were used in the acetabulum,the rest were cemented.Fifteen femoral prostheses were cementless and another 29 were cemented.Results:The incision were healed smoothly.The follow-up period was from 6 months to 5 years.The mean Harris score was 93.4.Radiographic evaluation demonstrated no evidence of subsidence of the femoral prosthetic stem.The clinical outcome of this group was patisfactory and the hip joint function improved obviously after operation.Conclusion:With the improvement in the technology、material and designing,the total hip replacement was an effective method in the treatment of hip osteoarthritis secondary to trauma.The changes of pathology of hip secondary to traumata should be considered before opeation.It was a challenging work to the orthopedic surgeon and careful preoperative designing was strongly recommended.

关 键 词：创伤性 骨关节炎 人工关节置换 全髋关节置换 股骨头脱位 

分 类 号：R687.4[医药卫生—骨科学]