摘要
目的探讨解剖型股骨假体置换治疗重度髋关节发育不良（developmental dysplasia of the hip,DDH）的疗效。方法回顾分析2009年9月-2013年9月,48例（51髋）因重度DDH选择解剖型股骨假体行初次人工全髋关节置换术患者的临床资料。男5例（5髋）,女43例（46髋）;年龄28～67岁,平均51岁。左髋25例,右髋20例;双髋3例。根据Crowe分型标准：Ⅲ型39例（44髋）,Ⅳ型9例（7髋）。患者术前疼痛视觉模拟评分（VAS）为（5.72±1.84）分,Harris评分为（41.66±4.87）分。术前肢体短缩长度（4.31±0.84）cm。结果手术时间59～110 min,平均78.6 min;住院时间6～20 d,平均12.3 d。术后切口均Ⅰ期愈合,2例并发下肢肌间静脉血栓形成。患者均获随访,随访时间10～54个月,平均29个月。9例术后早期伴跛行步态,1年内消失;其余患者步态均正常。末次随访时,VAS评分为（1.46±0.47）分,Harris评分为（88.66±3.48）分,健患侧肢体长度相差（1.15±0.33）cm,与术前比较差异均有统计学意义（P〈0.05）。X线片复查示,随访期间均无假体松动、下沉、异位骨化、骨质溶解并发症发生。结论采用解剖型股骨假体置换治疗重度DDH,能有效缓解疼痛,改善关节功能,恢复肢体短缩,近期疗效满意。
Objective To evaluate the effectiveness of anatomic femoral component prosthesis for severe development dysplasia of the hip（DDH） in total hip arthroplasty（THA）. Methods Between September 2009 and September 2013, 48 patients（51 hips） with severe DDH underwent THA with cementless anatomic femoral component prosthesis. There were 5 males（5 hips） and 43 females（46 hips） with an average age of 51 years（range, 28-67 years）. The left hip was involved in 25 cases, the right hip in 20 cases, and bilateral hips in 3 cases. There were 39 cases（44 hips） of Crowe type III and 9 cases（7 hips） of Crowe type IV. The visual analogue scale（VAS） score was 5.72±1.84, and Harris score was 41.66±4.87 at preoperation. All patients had leg discrepancy with a length difference of（4.31±0.84） cm. Results The duration of surgery was 59-110 minutes（mean, 78.6 minutes）, and the hospitalization days were 6-20 days（mean, 12.3 days）. All patients obtained primary healing of incision without wound related complications of swelling, effusion, and infection. Two patients were found to have intramuscular venous thrombosis. All patients were followed up 10-54 months（mean, 29 months）. Limp was observed at the early stage after operation in 9 patients and disappeared after 1 year, the other patients had normal gait. The VAS score 1.46±0.47, Harris score 88.66±3.48, and the leg length difference（1.15±0.33） cm at last follow-up all showed significant differences when compared with the preoperative values（P0.05）. No prosthesis loosening or subsidence, heterotopic ossification, dislocation, and infection occurred. Conclusion Anatomic femoral component prosthesis for severe DDH in THA can relieve pain, and improve the hip joint function and limb discrepancy. Short-term effectiveness was satisfactory, but the long-term effectiveness should still be observed in future.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2015年第4期431-434,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
髋关节发育不良
人工全髋关节置换术
解剖型股骨假体
Developmental dysplasia of the hip Total hip arthroplasty Anatomic femoral component prosthesis
作者简介
通信作者：董纪元，主任医师，硕士生导师，研究方向：关节外科，E-mail：dongfiyuan81301@163．com．
