仿生双动关节重建髋关节的稳定性  

Reconstruction of the hip joint stability with the dual-mobility acetabular cup

作　　者：艾进伟[1] 韩叶萍[1] 李光辉[1] 杜晨飞 孙永强[1] 

机构地区：[1]河南中医药大学第二附属医院骨伤诊疗中心,河南省郑州市450002

出　　处：《中国组织工程研究》2017年第27期4271-4276,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:髋部不稳,如脑瘫、偏瘫、小儿麻痹后遗症以及臀中肌广泛损伤的髋关节置换和关节置换后反复脱位翻修患者髋部肌力失衡,术后脱位率高,仍是临床医生的巨大挑战。目的:观察仿生双动关节对重建髋关节稳定性的影响,防止髋部神经肌肉病变关节置换术后脱位。方法:纳入2010年1月至2014年7月河南中医药大学第二附属医院骨科收治的12例偏瘫、小儿麻痹后遗症、髋臼发育不良以及髋关节置换术后反复脱位患者,采用仿生双动关节行关节置换或翻修,通过调整外展肌力臂实现髋部的动力稳定。结果与结论:①随访时间20-60个月;②1例1年后摔倒右股骨假体周围骨折、保守治疗;1例术后1周脱位1次,其余病例未出现脱位、感染、松动征象;③结果表明,髋部神经肌肉病变、髋部不稳患者的髋关节置换,选择仿生双动髋关节假体,能够重建髋关节稳定性,防止术后脱位发生。BACKGROUND： Patients with hip instability due to cerebral palsy, hemiplegia, infantile paralysis and extensive damage in gluteus medius, appear with high dislocation rate after arthroplasty, which is a great challenge for clinicians.OBJECTIVE： To investigate the reconstruction of the hip joint stability with the dual-mobility acetabular cup, and to prevent the dislocation after replacement in patients with hip neuromuscular lesions.METHODS： Twelve cases of hemiplegia, infantile paralysis, developmental dysplasia of the hip and recurrent dislocation after hip arthroplasty admitted in the Orthopedic Treatment Center, the Second Affiliated Hospital of Henan University of Chinese Medicine from January 2010 to July 2014 were enrolled, then underwent joint replacement or revision with dual-mobility cup, and the dynamic stability of the hip was achieved by adjusting the abductor lever arm.RESULTS AND CONCLUSION： （1） The followed-up time was from 20 to 60 months. （2） One year later, one case suffered Vancouver A right femoral fracture and received conservative treatment at 1 year postoperatively; one case of dislocation at postoperative 1 week, and dislocation, infection and loosening occurred in none cases. （3） These results manifest that those patients with neuromuscular disease and hip instability treated with hip joint arthroplasty using dual-mobility acetabular cup can reconstruct the stability of the hip joint and prevent the occurrence of postoperative dislocation.

关 键 词：骨科植入物 人工假体 髋部不稳 关节置换 仿生双动髋关节 外展功能重建 髋部神经肌肉病变 术后脱位 

分 类 号：R318[医药卫生—生物医学工程]