联合前倾角技术在成人发育性髋关节发育不良全髋关节置换术中的应用

目的探讨联合前倾角技术在成人发育性髋关节发育不良全髋关节置换术中应用的可行性及临床价值。方法回顾性分析自2016-09—2018-06采用联合前倾角技术行全髋关节置换术治疗的31例(36髋)成人发育性髋关节发育不良,比较手术前后髋臼前倾角、股骨前倾角、联合前倾角及髋关节功能Harris评分。结果31例均获得12个月以上随访。术后骨盆正位及髋关节侧位X线片显示假体位置及对应关系良好,无假体松动、下沉,无脱位表现。末次随访时所有患者步态均明显改善,髋部疼痛均消失,仅2例轻度跛行。术后髋臼前倾角、股骨前倾角、联合前倾角较术前明显减小,末次随访时髋关节功能Harris评分较术前明显增加,差异有统计学意义(P<0.05)。结论联合前倾角技术应用于成人发育性髋关节发育不良全髋关节置换术对于指导合适假体的选择、设计以及确定合适的髋臼前倾角、股骨柄前倾角具有重要意义,良好的联合前倾角能够有效预防术后假体脱位的发生。

Application of combined anteversion technique in total hip arthroplasty for adult developmental dysplasia of hip

Objective To investigate the application of combined anteversion technique in total hip arthroplasty for adult developmental dysplasia of hip.Methods A retrospective analysis was performed on 31 cases(36 hips)of adult developmental dysplasia of the hip after total hip arthroplasty with combined anteversion technique from September 2016 to June 2018.The acetabular anteversion,femoral neck anteversion,combined anteversion and Harris score of hip function before and after surgery were compared.Results All 31 cases were followed up for more than 12 months.After the operation,the X-ray of the positive position of the pelvis and the lateral position of the hip joint showed that the position and corresponding relationship of the prosthesis were good.At the last follow-up,gait of all patients was significantly improved,hip pain disappeared,and only 2 patients had mild claudication.The acetabular anteversion,femoral neck anteversion and combined anteversion significantly decreased and the Harris score of hip function at the last follow-up significantly increased after operation,with statistically significant differences(P<0.05).Conclusion The application of combined anteversion technique in the total hip arthroplasty of the adult developmental hip dysplasia is of great significance in guiding the selection,design and determination of appropriate acetabular and femoral stem anteversion.Good combined anteversion can effectively prevent the occurrence of postoperative dislocation of prosthesis.