摘要
目的:对比研究双切口全髋关节置换术治疗股骨头坏死或髋关节发育不良的疗效。方法:2010年9月至2018年3月三家医院收治157例患者进行双切口全髋关节置换术。其中159个髋关节(股骨头坏死组99个,髋关节发育不良组60个)均采用双切口全髋关节置换术进行治疗,本研究对患者的临床资料和影像学检查结果进行回顾性分析,对髋臼杯倾斜角度和前倾角、股骨柄对齐和股骨管充填率和各组的植入物、松动或手术失败情况进行统计。结果:两组手术时间、出血量、伤口大小、住院天数、术后Harris髋关节评分或WOMAC量表差异无统计学意义(P>0.05)。股骨头坏死组与发育不良组相比,有较大的髋臼杯(P=0.028),但股骨柄大小相似(P>0.05)。两组的髋臼杯倾角差异无统计学意义(43.7°±4.8°比42.8°±5°)(P=0.440)。末次随访,有三例患者进行了翻修术(发育不良组有1例脓毒性松动,股骨头坏死组有2例假体周围骨折)。在本研究中没有发现脱位的病例。双切口全髋关节置换术中髋臼杯存活率为99.4%,股骨柄存活率为98.1%。结论:双切口全髋关节置换术对于治疗股骨头坏死或髋关节发育不良有一定的疗效。
Objective:To determine the efficacy of double-incision total hip replacement for the treatment of femoral head necrosis vs hip dysplasia.Methods:A total of 157 patients who underwent double-incision total hip arthroplasty in three hospitals between September 2010 and March 2018 were included,comprising 159 hip joints(99 assigned to the femoral head necrosis group and 60 to the hip dysplasia group).All subjects underwent double-incision total hip replacement.The clinical data and imaging findings of the patients were retrospectively analyzed.The tilt angle and anteversion of acetabular cup,femoral stem alignment and femoral canal fill ratio,the implants,implant loosening or surgical failure were statistically analyzed and compared between groups.Results:There were no significant differences between the two groups in operation time,blood loss,wound size,length of hospital stay,postoperative Harris Hip Score(HHS)or Western Ontario and McMaster Universities Arthritis Index(WOMAC)score(P>0.05).Compared with the hip dysplasia group,the femoral head necrosis group had larger acetabular cups(P=0.028)but similar size of femoral stem(P>0.05).There was no significant difference in the tilt angle of the acetabular cup between the two groups(43.7°±4.8°vs 42.8°±5°)(P=0.440).At the last follow-up,three patients underwent revision surgery(one septic loosening in the hip dysplasia group and two periprosthetic fractures in the femoral head necrosis group).No cases of dislocation were found.With the double-incision total hip replacement,99.4%of the acetabular cup and 98.1%of the femoral stem survived.Conclusion:Double-incision total hip replacement demonstrates certain efficacy in treatment of femoral head necrosis or hip dysplasia.
作者
林军
郑秋坚
臧学慧
邱忠鹏
高立华
Lin Jun;Zheng Qiujian;Zang Xuehui;Qiu Zhongpeng;Gao Lihua(Department of Joint Surgery,Nanhai Hospital Affiliated to Southern Medical University;Department of Joint Surgery,Guangdong Provincial People’s Hospital;Orthopedics Center,First Affiliated Hospital of Shihezi University Medical College,Foshan 528200,Guangdong,China)
出处
《广州医科大学学报》
2020年第3期34-38,共5页
Academic Journal of Guangzhou Medical University
基金
广东省医学科研基金(B2019166)。
关键词
双切口手术
发育不良
全髋关节置换术
骨坏死
Double-incision surgery
dysplasia
total hip replacement
osteonecrosis
作者简介
通讯作者:林军,Email:nh_linjun@163.com。