CroweⅢ-Ⅳ型DDH患者全髋关节置换术后不满意及相关因素分析  

Analysis of dissatisfaction and related factors following total hip arthroplasty in patients with Crowe typeⅢ-Ⅳdevelopmental dysplasia of the hip

作　　者：赵鹏[1] 李玉军[2] 窦勇[2] 王达成[2] ZHAO Peng;LI Yu-jun;DOU Yong;WANG Da-cheng(Department of Orthopaedics,Peking University Third Hospital Yanqing Distric Hospital,Beijing 102100,Chnia;Department of Orthopaedics,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京大学第三医院延庆医院,北京市延庆区医院骨科,北京102100 [2]北京积水潭医院矫形科,北京100035

出　　处：《中国骨伤》2024年第4期363-367,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨全髋关节置换术的CroweⅢ-Ⅳ型发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患者的满意度及造成不满意的相关因素。方法:回顾性分析2013年3月至2018年3月行全髋关节置换术的169例CroweⅢ-Ⅳ型DDH患者,通过微信进行调查问卷,调查患者对手术总体满意度、10项日常功能满意度和患者认为对自己日常生活影响比较大的前5个问题。手术前后采用髋关节Harris评分进行功能评价。结果:收到完整调查问卷145份,所有患者获随访,时间1~5(3.23±1.22)年。145例患者分成两组,其中对手术疗效满意的118例,不满意的27例,手术总体满意率81.38%(118/145)。患者认为对生活影响比较大的前5个问题分别是术后髋部疼痛,肢体明显不等长、行走、上下楼梯、蹲起。两组术前Harris评分比较,差异无统计学意义(P>0.05),不满意组术后Harris评分较低。术后髋关节疼痛、肢体不等长是影响手术不满意的直接因素。结论:采用全髋关节置换术治疗CroweⅢ-Ⅳ型DDH患者手术难度大;术后髋关节疼痛(轻度以上),肢体不等长(>2 cm)是术后不满意的独立危险因素。Objective To investigate the satisfaction of patients with CroweⅢ-Ⅳdevelopmental dysplasia of the hip(DDH)after total hip arthroplasty and the related factors.Methods A retrospective study included 169 patients with Crowe typeⅢ-ⅣDDH who underwent total hip arthroplasty between March 2013 and March 2018.Patients were surveyed through WeChat,covering overall satisfaction with the operation,satisfaction with ten daily functions,and the top five questions perceived to have a great impact on daily life.Preoperative and postoperative hip function was evaluated by Harris score.Results One hundred and forty-five questionnaires were received,with a follow-up period ranging from 1 to 5 years with an average of(3.23±1.22)years.Among these patients,118 patients were satisfied with the surgical outcomes,while 27 patients were dissatisfied,with the overall satisfaction rate of 81.38%(118/145).The top five problems affecting patient life were postoperative hip pain,limb length discrepancy,walking,stair climbing,and squatting.There were no statistical differences in age,sex,body mass index,preoperative Harris scores(P>0.05).However,the dissatisfied group had lower postoperative Harris scores.Postoperative hip pain and limb length discrepancy were identified as direct factors contributing to postoperative surgical dissatisfaction.Conclusion Total hip arthroplasty for patients with Crowe typeⅢ-ⅣDDH is challenging.Postoperative hip pain(mild or severe)and limb length discrepancy(>2 cm)are independent risk factors for postoperative dissatisfaction.

关 键 词：高脱位 髋关节发育不良 CroweⅢ-Ⅳ 全髋关节置换 满意度 

分 类 号：R687.42[医药卫生—骨科学]