髋臼结构植骨在Crowe Ⅲ或Ⅳ型髋关节发育不良关节置换术中的应用  

Total hip replacement with bulk autograft in developmental dysplasia of the hip （ Crowe type Ⅲ or Ⅳ）

作　　者：朱俊峰[1] 陈晓东[1] 沈超[1] 崔一民[1] 蔡贵泉[1] 

机构地区：[1]200092上海交通大学医学院附属新华医院骨科

出　　处：《中华解剖与临床杂志》2014年第1期15-18,共4页Chinese Journal of Anatomy and Clinics

基　　金：国家自然科学基金（81171705,81101381,81101379）;上海交通大学医学院科技基金资助（YZ1002）

摘　　要：目的探讨髋臼结构植骨在CroweⅢ、Ⅳ型髋关节发育不良（DDH）人工全髋关节置换术（THR）中应用的短期效果。方法对2008年7月—2011年6月，全髋关节置换术（THR）中采用结构性植骨结合非骨水泥臼杯进行髋臼侧重建治疗的38例43髋Crowe Ⅲ型或Ⅳ型DDH患者的短期疗效进行回顾性分析。男5例（5髋），女33例（38髋），平均年龄41岁。术前Harris评分平均51分，19髋术中联合行转子下横行短缩截骨，平均1．6cm。结果术后平均随访39个月。末次随访Harris评分平均92分。肢体长度差异由术前的平均4．4cm减少至术后0．7cm。术后髋关节旋转中心平均下移3．2cm，内移2．8cm。所有髋臼假体无松动或感染，髋臼结构植骨块均愈合。术后异位骨化1髋，关节脱位1髋，闭合复位成功。结论自体结构性植骨结合非骨水泥臼杯重建Crowe Ⅲ、Ⅳ型髋关节发育不良的旋转中心，短期效果令人满意，无植骨不愈合、骨块吸收或松动等并发症。Objective To investigate the preliminary result of total hip replacement （THR） with bulk autograft in high hip dysplasia. Methods From July 2008 to June 2011,38 patients （5 males and 33 females） with high hip dysplasia （Crowe type IU or IV） were treated with THR and bulk autograft. Femoral osteotomy was performed in 19 hips with an average shortening of 1.6 cm. The average age of the patients at the time of index procedure was 41 years. The average preoperative Harris score was 51. Results The mean follow-up period was 39 months. The average postoperative Harris score was 92. Leg length discrepancy decreased from preoperative 4.4 cm to postoperative 0.7 cm. The hip center of rotation removed distally and medially with mean distance of 3.2 cm and 2.8 cm, respectively. No infection, bone nonunion or loosening was found. There was one case of heterotopic ossification and one case of hip dislocation which was successfully reduced with close reduction. Conclusions Satisfactory preliminary results can be obtained through total hip arthroplasty and bulk autograft in patients with developmental dysplasia of the hip.

关 键 词：髋关节发育不良 全髋关节置换 结构植骨 截骨 

分 类 号：R687.4[医药卫生—骨科学]