髋臼内壁截骨全髋关节置换术治疗髋关节发育不良  

Early Clinical Effect of the Osteotomy of Acetabular Medial Wall in Total Hip Arthroplasty for Treatment of Developmental Dysplasia of Hip

作　　者：李广彬[1] 陈秀民[1] 王在斌[1] 齐志远[1] 韩鹏[1] 姜志圣[1] 马士超[1] 

机构地区：[1]濮阳市中医院骨科,河南濮阳457000

出　　处：《实用骨科杂志》2016年第4期305-309,共5页Journal of Practical Orthopaedics

摘　　要：目的探讨髋臼内壁截骨全髋关节置换术治疗髋关节发育不良(CroweⅡ、Ⅲ型)并骨关节炎的近期临床疗效和手术技术。方法 2011年5月至2015年2月,采用结合髋臼内壁截骨全髋关节置换术治疗髋关节发育不良(CroweⅡ、Ⅲ型)合并骨关节炎患者共19例,其中男2例2髋,女17例18髋,于术后3、6、12个月及以后每年随访一次,通过拍摄X线片观察患者臼杯有无松动,臼底截骨愈合情况。通过对髋关节进行Harris评分和疼痛视觉模拟评分(visual analogue scale,VAS),评估近期疗效。结果 18例得到随访,患者术前及术后采用Harris评分,其中11例由术前平均(76.52±3.08)分,增至术后(97.39±2.32)分,4例由术前平均(59.32±6.08)分,增至术后(74.39±5.12)分,优良率为83.33%。术前术后关节活动度及Harris评分、VAS评分比较差异具有统计学意义(P<0.01)。所有患者术后均无伤口感染,假体松动及关节脱位等并发症。结论髋臼内壁截骨全髋关节置换术治疗髋关节发育不良(CroweⅡ、Ⅲ型)并骨关节炎是一种有效的治疗方法,近期疗效满意。Objective To explore the early-term clinical effects and surgical technique of osteotomy of acetabular medial wall in total hip arthroplasty（ THA） for developmental dysplasia of hip（ DDH） of Crowe Ⅱ Ⅲ type. Methods From May2011 to February 2015,nineteen patients of DDH with osteoarthritis received osteotomy of acetabular medial wall in THA（ 2male 2 hips,17 female 18hips）. Whether the acetabular cup was loose,as well as whether achieving bony union would be checked through the X-ray. All the cases were followed up in 3、6 and 12 months after operation and all patients were evaluated with Harris hip score and VAS hip score. Results Eighteen cases were followed up,patients were accessed by Harris score both before and after operation changed. In 11 cases,the Harris score improved from 78. 32（ 76. 52 ± 3. 08） before operation to96. 46（ 97. 39 ± 2. 32） after operation,and 4 cases with an average of 64. 81（ 59. 32 ± 6. 08） points preoperatively rose to87. 36（ 74. 39 ± 5. 12） points. The excellent and good rate was 83. 33%. Preoperative ROM,Harris hip score and VAS hip score were very different from postoperative,which was a statistical difference（ P〈0.01）. No patients had a postoperative wound infection and complication such as prosthetic loosening and joint dislocation. Conclusion Osteotomy of acetabular medial wall in THA is effective for treatment of DDH（ Crowe Ⅱ Ⅲ type） with osteoarthritis,and the short-term effects are satisfactory.

关 键 词：髋臼发育不良 骨关节炎 臼底截骨 

分 类 号：R687.42[医药卫生—骨科学]