高髋中心技术在髋关节发育不良患者全髋关节置换术中的应用  

High Hip Center Technique in Total Hip Replacement for Developmental Dysplasia of the Hip

作　　者：谭英铨 高大伟 陈亮 

机构地区：[1]广州中医药大学附属中山中医院,广东中山528401

出　　处：《中国中医骨伤科杂志》2023年第5期35-39,44,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：中山市社会公益与基础研究项目(2020SYF03);中山市科技局项目(2022B1124)。

摘　　要：目的:探究人工全髋关节置换术(THR)中应用高髋中心技术治疗CrowelⅡ、Ⅲ型髋关节发育不良(DDH)患者的临床疗效。方法:选取2017年1月至2021年6月行人工全髋关节置换术治疗的64例(78髋)CroweⅡ、Ⅲ型发育性髋关节发育不良患者进行随访,按照髋臼杯位置及Crowe分型分为3组,H2组(高位Ⅱ型)、H3组(高位Ⅲ型)、A组(解剖Ⅱ型)。比较3组Trendelenburg征、Harris评分、步态情况、术后双下肢长度差。结果:所有患者术后步态良好,无跛行,高位组术中出血量与手术时间均优于解剖组,差异有统计学意义(P<0.05)。3组术后1年Harris评分、术后引流量、下地时间、双下肢长度差的差异均无统计学意义(P>0.05)。结论:高髋中心技术是全髋关节置换术治疗CroweⅡ、Ⅲ型发育性髋关节发育不良髋臼重建的一种有效的选择,能获得良好的临床疗效,可缩短手术时间,简化手术过程,减少术中出血量。Objective:To explore the efficacy of high hip center technique in toal hip replacement(THR) for Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip(DDH).Methods:64 patients(78 hips) with Crowe Ⅱ to Ⅲ DDH who received total hip replacement from January 2017 to June 2021 were followed up and divided into three groups according to the location of acetabular cups and the type of Crowe.Group H2(high hip center Ⅱ),Group H3(high hip center Ⅲ) and group A(anatomical position Ⅱ).Trendelenburg sign, Harris score, operation time, intraoperative blood loss, leg length discrepancy were compared among the three groups.Results:All patients had good postoperative gait.The operative time and intraoperative bleeding in the high group were not more than the anatomic group(P<0.05).However, there was no significant statistical difference in Harris score, postoperative drainage, lower limb length difference, and time spent on the ground between the two groups at 1 years after surgery(P>0.05).Conclusion:High hip center technique in THR for Crowe Ⅱ and Ⅲ developmental dysplasia of the hip is a valuable alternative to achieve excellent clinical efficacy, which can reduce intraoperative bleeding, simplify the opertation process and shorten the operation time.

关 键 词：髋臼高位放置 髋关节发育不良 全髋关节置换术 髋臼重建 高髋中心 

分 类 号：R687.4[医药卫生—骨科学]