全髋关节置换术治疗髋关节发育不良的髋臼重建  

Acetabular reconstruction in total hip replacement for developmental dysplastic hips

作　　者：勘武生[1] 郑琼[1] 黄珩[1] 魏忠民[1] 陈明[1] 王俊文[1] 李鹏[1] 彭永海[1] 

机构地区：[1]华中科技大学附属普爱医院(武汉市骨科医院骨科),武汉430033

出　　处：《中华创伤骨科杂志》2007年第9期820-823,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨全髋关节置换术治疗髋关节发育不良过程中髋臼重建的方法及临床效果。方法1996年7月～2006年7月收治36例髋关节发育不良患者，按Crowe方法分型：Ⅰ型13例，Ⅱ型8例，Ⅲ型8例，Ⅳ型7例，所有患者均进行全髋关节置换术，术中采用自体股骨头及髂骨在髋臼周围做结构性植骨，髋臼旋转中心内移重建髋臼。术前和随访时采用摄片观察和Harris评分对髋关节功能进行评估。结果术后随访9个月～10年（平均6．3年）。所有移植骨块经X线片证实均与宿主骨愈合，无骨吸收现象，植骨块对髋臼的平均覆盖率为35％，未见假体松动，关节疼痛缓解，活动功能满意。Harris评分术前平均40．6分，术后平均90．3分，近中期随访效果良好，暂无二期翻修病例。结论采用自体股骨头及髂骨结构性植骨、髋臼旋转中心内移重建髋臼的髋关节置换术是治疗髋关节发育不良的有效方法。Objective To investigate the clinical effect of acetabular reconstruction in total hip replacement （THR） for developmental dysplastic hips （DDH）. Methods From July 1996 to July 2006, 36 adult patients with hip osteoarthritis secondary to dysplasia received THR. According to Crowe classification of hip subluxation or dislocation, 13 hips were of type Ⅰ, 8 of type Ⅱ, 8 of type Ⅲ and 7 of type Ⅳ. Acetabular reconstruction included bulk structural autogenous grafts of femoral head or ilium and medial shift of acetabular rotation centre. Radiography and Harris hip scoring were performed to evaluate the hip function preoperatively and at the follow-up. Results The mean follow-up period was 6. 3 years （range, 9 months to 10 years）. Radiography showed that all the gratis united to the host bone and no bone absorption appeared. No joint loosening was found in this group. The mean Harris score increased from 40.6 preoperatively to 90.3 at the time of last follow-up. All the patients were satisfied with relieved joint pain and joint movement. Conclusion Bulk structural autogenous grafts of femoral head or ilium and medial shift of the acetabular rotation centre are effective ways to reconstruct the acetabulum in the treatment of DDH.

关 键 词：关节成形术 置换 髋 髋关节发育不良 髋臼重建 

分 类 号：R686[医药卫生—骨科学]