全髋关节置换术治疗成人髋关节发育不良继发严重骨关节炎  

THR for severe osteoarthritis secondary to the DDH in adult

作　　者：金今[1] 孙武[1] 邱贵兴[1] 翁习生[1] 林进[1] 赵庆[1] 费琦[1] 赵丽娟[1] 

机构地区：[1]北京协和医院骨科,北京100730

出　　处：《中国医刊》2008年第4期42-44,共3页Chinese Journal of Medicine

摘　　要：目的评价全髋关节置换术治疗成人髋关节发育不良继发严重骨关节炎的疗效和安全性。方法从2001年9月至2007年2月,32例(37髋)髋关节发育不良继发严重骨关节炎的患者接受了人工全髋关节置换术,其中男1例,女31例(5例为双髋),年龄36～86岁,平均58岁。按Crowe分型分类:Ⅰ型3髋,Ⅱ型13髋,Ⅲ型14髋,Ⅳ型7髋。术前平均Harris评分47.8分。结果所有患者均随访6个月至6年(平均2年7个月),最终随访时Harris评分为84.1分,优良率达93.7%,未见感染、无菌性松动和假体下沉等并发症的征象。结论对于髋关节发育不良继发严重骨关节炎的成人患者,如能制定严密的术前计划、处理好病变髋臼重建、选择合适股骨假体、正确处理股骨近段并同时准备好植骨来源,全髋关节置换术可取得良好的临床结果。Objective To evaluate efficiency and safety of total hip replacement （THA） in the treatment of severe osteoarthritis secondary to developmental dysplasia of the hip（DDH） in adult. Methods From September 2001 to February 2007, a total of 32 patients （37 hips） of severe osteoarthritis secondary to DDH underwent total hip replacement. 1 was male and 31 were female, with their ages ranging from 36 to 86 years and an average age of 58 years. According to Crowe classification, there were type Ⅰ in 3 hip, type Ⅱ in 13 hip, type Ⅲ in 14 hip, and type Ⅳ cases in 7 hip. The preoperative average Harris Score was 47.8. The bilateral arthroplasty was performed in 5 patients and the unilateral arthroplasty in 27 patients. The patients mainly suffered from pain and claudication. Clinical and radiological results were analyzed. Results The mean follow-up period was 31 months （ ranged from 6 months to 6 years）. The latest follow-up average Harris Score was 84.1 （93.7% of good rate）. All the patients were pain-free and there was no sign of infection, aseptic loosening and subsidence. Conclusion Total hip replacement is a good treatment method for severe osteoarthritis secondary to DDH in adult. The key techniques for the total hip replacement are as follows ： good preoperative plan, firmly placing the acetabular component in the true acetabulum, proper preparation of proximal femur, suitable femoral component choosing and improving the techniques of the bone graft.

关 键 词：成人 骨关节炎 髋关节发育不良 全髋关节置换术 

分 类 号：R681.1[医药卫生—骨科学]