全髋关节置换治疗成人髋关节发育不良继发严重骨关节炎26例  

Total hip arthroplasty for severe osteoarthritis secondary to adult developmental dysplasia of the hip in 26 cases

作　　者：刘鸿程[1] 陈路[2] 陈轼[2] 彭慕牛[2] 邹玉莲[1] 赖优良[1] 刘文和[3] 

机构地区：[1]岳阳职业技术学院附属医院骨科,湖南省岳阳市414000 [2]岳阳职业技术学院护理学院,湖南省岳阳市414000 [3]湘南学院附属医院骨科,湖南省郴州市423000

出　　处：《中国组织工程研究与临床康复》2009年第9期1739-1742,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：回顾性分析2008-08/2007-02湘南学院附属医院骨科与岳阳职业技术学院附属医院骨科收治的成人髋关节发育不良继发骨性关节炎患者26例(29髋),男11例,女15例;年龄46～78岁,平均53岁;其中3例为双髋。按Crowe分型分类:Ⅰ型3髋,Ⅱ型11髋,Ⅲ型12髋,Ⅳ型3髋。置换前按Harris评分标准平均(47.1±4.6)分。全部患髋均行全髋关节置换,骨水泥型3例,混合型5例,生物型21例。所有患者置换顺利进行,置换后伤口均Ⅰ期愈合。置换后5个月,患者均能下地行走,生活自理且恢复日常工作。全部患者获得随访,末次随访时Harris评分平均(84.5±6.4)分,与置换前Harris评分平均(47.1±4.6)分相比,差异有显著性意义(t=16.7324,P<0.05)。26例患者置换后关节脱位1例,精神症状2例。随访X射线检查示假体位置良好,未见无菌性松动和假体下沉等征象。无肺栓塞、深静脉血栓形成、感染等并发症发生。提示全髋关节置换是治疗成人先天性髋关节脱位伴骨性关节炎的一种有效方法。Twenty-six patients （29 hips） with severe osteoarthritis secondary to developmental dysplasia of the hip underwent total hip arthroplasty in Department of Orthopaedics, Affiliated Hospital of Yueyang Vocational Technical College, and Department of Orthopaedics, Affiliated Hospital of Xiangnan University between August 2000 and February 2007, including 11 males and 15 females aged 46 to 78 years （mean 53 years）. Three of them involved bilateral hips. According to Crowe classification, there were type Ⅰ in 3 hips, type Ⅱ in 11 hips, type Ⅲ in 12 hips, and type Ⅳ in 3 hips. The preoperative average Harris score was 47.1±4.6. The cement prosthesis arthroplasty was performed in 3 patients, mixture arthroplasty in 5 patients and biotype in 21 patients. The operations had been performed successfully, and the incision had healed well. All patients walked independently, and took care of themselves and returned to the job 5 months post-operation. All patients were followed up, and at the final follow up, the average Harris score was 84.5±6.4, which had statistical significance compared to pre-operation functional scores （t=16.732 4, P〈 0.05）. All the patients were pain-free and there was no sign of infection, aseptic loosening and subsidence. The peri-operative and post-operative complications happened in 3 cases： the dislocation of hips in 1 case, and mental symptoms in 2 cases respectively. The position of the components were radiographic satisfactory. Total hip arthroplasty is an effective way in treating osteoarthritis resulted from congenital dislocation of the hip.

关 键 词：成人 骨关节炎 髋关节发育不良 全髋关节置换 

分 类 号：R684[医药卫生—骨科学]