全髋置换术治疗Perthes病后遗症的中期临床结果  

Total hip arthroplasty for treatment of sequelae of Legg-Cavé-Perthes Disease: a mid-term follow-up results

作　　者：黄德勇[1] 胡德炜 张亮[1] 黄勇[1] 周一新[1] 

机构地区：[1]北京积水潭医院矫形骨科,北京西城区新街口东街31号100035 [2]江西省奉新县人民医院骨科,江西省宜春市奉新县330700

出　　处：《中国矫形外科杂志》2016年第13期1189-1193,共5页Orthopedic Journal of China

摘　　要：[目的]评价全髋置换术治疗Perthes病后遗症的中期临床疗效和影像学结果。[方法]对2004年2月～2013年10月间因Perthes病继发髋关节骨关节炎而行全髋置换术的33例患者（33髋）进行回顾性分析,其中男性18例18髋和女性15例15髋,患者手术时平均年龄46.8岁（24～72岁）,全部病例均采用非骨水泥型臼杯重建髋臼和非骨水泥柄重建股骨近端,其中11髋使用组配式股骨假体。临床结果采用Harris髋关节评分进行评价,影像学结果依据术后系列X线片进行评估。[结果]平均随访时间53.4个月（26～136个月）,Harris髋关节评分从术前平均37.6分（15～56分）提高至术后最后一次随访的92.8分（70～100分）（P〈0.001）。术后有7例患者仍然存在中度至重度跛行。围手术期并发症包括坐骨神经损伤1例和术中股骨距骨折4例,未发现假体无菌性松动及深部感染病例。[结论]尽管技术上存在众多难点,但全髋关节置换术治疗Perthes病后遗症的中期临床和影像学结果令人满意,某些并发症发生率高值得关注。[Objective] To evaluate the medium- term clinical and radiographic results following total hip arthroplasty（ THA） for the treatment of sequelae of Legg- Cavé- Perthes disease. [Methods] Between Feb 2004 and Oct 2013,33 patients（ 33 hips） diagnosed as having sequelae of Legg- Cavé- Perthes disease,including 18 male and 15 female,were treated with total hip arthroplasty and retrospectively reviewed. The patients＇ average age was 46. 8 years（ range,24 ～ 72 years）. Cementless cups and stems were used and inserted in all hips,and 11 hips were reconstructed by modular stems. Clinical results were evaluated by Harris hip score and radiographic results were analyzed by postoperative serial X- ray films. [Results] The average duration of follow- up was 53. 4 months（ range,26- 136 months）. The average Harris Hip score increased from preoperative 37. 6 points（ range,15 ～ 56 points） to 92. 8 points（ range,70 ～ 100 points） at the latest follow- up. Postoperative complications were limited to 7 case with moderate to heavy limp,1 case of sciatic nerve injury and 4 cases of intraoperative calcar fracture. [Conclusion] Despite the technically difficult nature of the procedure,the clinical and radiographic results of THAs in patients with sequelae of Legg- Cavé- Perthes disease are encouraging. However,the high incidence of some perioperative complications deserves attention.

关 键 词：PERTHES病 后遗症 全髋置换术 

分 类 号：R687.4[医药卫生—骨科学]