先天性髋关节发育不良伴继发性骨性关节炎的病理特点及全髋关节置换术近期疗效观察  

Pathologicd characteristics of osteoarthritis secondary to acetabular dysplasia and the short-term effects of total hip replacement

作　　者：孙卫平[1] 郝经鑫[1] 杜宏伟[1] 王善超[1] 

机构地区：[1]解放军第404医院骨科,山东威海264200

出　　处：《中国矫形外科杂志》2008年第17期1289-1291,1321,共4页Orthopedic Journal of China

摘　　要：[目的]探讨非骨水泥假体的全髋置换术治疗成人先天性髋臼发育不良伴继发性骨关节炎的经验及评价全髋置换术后的近期疗效。[方法]自2000年3月至2007年3月，对25例30髋成人先天性髋臼发育不良伴继发性骨关节炎的患者进行了非骨水泥假体的全髋置换术，其中男5例，女20例；年龄35～55岁，平均45岁，双侧5例，单侧20例。主要症状为疼痛及跛行。根据Hartofilakidis分类方法，半脱位2l髋，高位脱位9髋。[结果]经8个月～7年平均3年9个月的随访。Harris评分由术前36．09恢复到术后的88．21。所有病人患髋疼痛基本消失，可以长时间行走，X线片示人工髋关节位置良好，假体无松动及明显下沉迹象，生活自理并恢复日常工作。[结论]非骨水泥假体全髋关节置换术是治疗成人先天性髋臼发育不良伴继发性骨关节炎的有效方法。选择合适的假体，髋臼的加深及恰当的髋臼缺损处骨移植是手术成功的关键。[ Objective ] To summarize the experiences of total hip replacement with cementless joint components in the treatment of osteoarthritis secondary to acetabular dysplasia in adults and to evaluate its early effect. [ Method ] From March 2000 to March 2007, thirty hips in 25 adult patients with osteoarthritls secondary to acetabular dysplasia undergoing total hip re- placement with cementless joint components were included in this study. Of the patients, 5 were male and 20 were female. Their ages ranged from 35 to 55 years with an average age of 55 years. The patients mainly complained of pain and claudication. According to the Hartofilakidis classification , Semi - dislocation occurred in 21 hips and high - dislocation in 9 hips. Five patients underwent bilateral total hip replacements and twenty patients had unilateral total hip replacement. [ Result] The duration of follow -up ranged from 8 months to 7 years （ average 3 years and 9 months ） . The average Harris score was increased from 36.09 to 88.21 points, They could take care of themselves and returned to their previous job. All the patients were pain - free and there was no sign of aseptic looseing or subsidence. [ Conclusion ] Total hip replacement with cementless joint components is an effective method for the treatment of osteoarthritis secondray to acetabular dysplasia in adults. The key point to the success for operation are appropriate cementless joint components, deepened medial wall of the acetabulum and improved the techniques of bone graft in the true acetabulum.

关 键 词：关节成形术 髋臼发育不良 骨关节炎 置换 髋 

分 类 号：R687.4[医药卫生—骨科学]