人工全髋关节置换术治疗髋臼发育不良近期疗效观察  

Total Hip Arthroplasty for Acetabular Dysplasia

作　　者：张玉舰[1] 牛增广[1] 李玉强[1] 池青[1] 张玉龙[2] 张舸[1] 文立成[3] 

机构地区：[1]河北省秦皇岛市第一医院骨科,河北066000 [2]秦皇岛市第二医院骨科 [3]北京大学第一医院骨科

出　　处：《中国矫形外科杂志》2003年第22期1540-1542,共3页Orthopedic Journal of China

摘　　要：目的:探讨在髓臼发育不良的病例行人工全髋关节置换术时人工髋臼安放的方法。方法:对15例22个因髋臼发育不良导致骨关节炎的病例,在行人工全髋关节置换术时,根据髋臼发育不良的程度,采用了髋臼外上缘植骨,加深髋臼及髋臼轻度内陷等三种方法。术后3、6、9、12个月及以后每半年以同等条件投照双侧髋关节正位X线片,观察人工髋臼安放的角度及人工髋臼与髋臼骨床愈合的情况。平均随访24个月。结果:随访时发现加深髋臼及髋臼轻度内陷的病例,人工髋臼与髋臼骨床接触良好,角度满意,关节功能恢复优良。而髋臼外上缘植骨的病例,术后2年时植骨块与人工髋臼之间出现了透亮带。结论:髋臼发育不良导致髋关节骨关节炎的病例在施行人工关节置换术时应根据髋臼骨床的情况采用不同的手术方式安放人工髋臼。特别是在髋臼较浅,而髋臼骨床底部骨质较多的情况下,应采用向内切磨髋臼,加深髋臼后安放人工髋臼。本组病例大部分采取此方法,收到了十分满意的临床效果。但手术中应注意不宜切磨髋臼过深,影响到髋臼内壁的稳定。Objective: To study and discuss the install methods of hip prosthesis while perform a total hip arthroplasy for hypoplastic acetabulum. Methods: For 15 patients amount to 22 joints of osteoarthrasis due to hypoplasia of acetabulum, the authors adopted 3 methods to perform the total hip arthroplasty according to the developmental degree of acetabulum, which were implant bone on external upper lip of acetabulum, deepen acetabulum and slightly inward depening acetabulum. Took a X-ray photo for both joints with the same radiological condition in order to learn the installing angel of acetabulum and the coalescence of acetabulum with its bone bed after 3,6,9,12 months and every half a year of the operation.The average follow-up term were 24 months. Results:By follow-up, it was found that the acetabulum contacted well with its bed, the angle and the recovery of joint function was satisfied among the cases given the operation methods of deepen acetabulum and slightly inward deepened acetabulum. In the case of implanted bone on external upper lip of acetabulum, there was a zona pellucida between the implanted bone and the artificial acetabulum after 2 years of the operation. Conclusion: While performing total hip arthroplasty, various methods should be adopted according to the condition of the bed of acetabulum for the joints of osteoarthrasis due to hypoplasia of acetabulum. For the case of acetabulum shallowed and too much bone at the bottom of acetabulum bed, the surgeons should install the acetabulum by wear the acetabulum inward and deepen it. Be ware of not wearing the acetabulum too deeply to affecting the stability of the inner wall of acetabulum.

关 键 词：髋臼发育不良 骨性关节炎 关节成形术 人工全髋关节置换术 手术治疗 近期疗效 

分 类 号：R687[医药卫生—骨科学]