人工全髋关节置换治疗成人CroweⅣ型髋关节发育不良的要点  

Issues about total hip arthroplasty for severe adult developmental dysplasia of the hip

作　　者：张德宝[1] 刘凡 谷贵山 ZHANG De-bao;LIU Fan;GU Gui-shan(Department of Orthopaedics,The First Hospital of Jilin University,Changchun,Jilin,130021,China)

机构地区：[1]吉林大学第一医院骨关节外科,长春130021

出　　处：《中国骨与关节杂志》2023年第3期161-167,共7页Chinese Journal of Bone and Joint

摘　　要：发育性髋关节发育不良(developmental dysplasia of the hip,DDH)是1991年由美国骨科医师学会(American Academy of Orthopaedic Surgeons,AAOS)和北美小儿骨科学会(Pediatric Orthopaedic Society of North America,POSNA)结合髋关节发育的病理改变,定义为先天性髋关节脱位(congenital dislocation of the hip,CDH)更名后的概念。成人DDH发病率约为1‰,男女比例为1∶6,1/4患者有家族史[1],是导致髋关节骨关节炎及接受全髋关节置换术(total hip arthroplasty,THA)的常见原因[2],约占初次非创伤性THA的30%.Total hip arthroplasty(THA)is an effective method for adult developmental dysplasia of the hip(DDH).It can not only relieve pain and improve function,but also correct leg length discrepancy(LLD).For severe CroweⅣDDH,significant advantages have been achieved through THA,especially with the introduction of femoral prosthesis systems specifically designed for DDH,such as S-ROM,S-R,and etc.With the though understanding of the pathology of DDH and continuous improvement of surgical technique and femoral prosthesis system,great progress has been made for the treatment of DDH from the past several decades.However,due to the complexity of pathological anatomy,primary and secondary changes of CroweⅣDDH still pose a great challenge to surgeons.Therefore,this article aims at some issues of THA in the treatment of adult severe hip dysplasia(CroweⅣDDH),such as the fundamental pathology,indications for operation and the related techniques during the operation including soft tissue release,location of the true acetabulum,femoral osteotomy,selection of prosthesis,limb rehabilitation and psychological rehabilitation.

关 键 词：关节成形术 置换 髋 髋关节发育不良 髋关节 

分 类 号：R687.4[医药卫生—骨科学]