髋关节发育不良的全髋关节置换

目的 探讨髋关节发育不良继发性骨性关节炎的全髋关节置换,恢复正常髋臼旋转中心高度和下肢长度的方法.方法 1996年7月~2007年7月收治18例髋关节发育不良患者,按Crowe方法分析：I型7例,Ⅱ型4例,Ⅲ型4例,Ⅳ型3例.髋臼旋转中心的重建方法包括标准的全髋关节置换术、结构性自体植骨和旋转中心内移.术前和随访时采用摄片观察和Harris评分对髋关节功能进行评估.结果 术后随访9个月~10年（平均6.3年）,所有患者髋臼旋转中心都恢复正常,所有移植骨块经X线证实,均与宿主骨愈合,无骨块吸收现象,未见假体松动,关节疼痛缓解,活动功能满意.Harris评分术前平均45.6分,术后平均91.3分.结论 采用自体股骨头及髂骨结构性植骨,旋转中心内移重建髋臼的全髋关节置换术是活疗髋关节发育不良的有效方法.

Developmentaldy splastiship of the hip using total hip replacement

Objective To investigate the methods of restoring normal level of revolution center of the hip and limb length in patients with osteoarthritis secondary to developmental dysplasia of the hip using total hip replacement. Methods From July 1996 to July 2007,18 adult patients with hip osteoarthritis secondary to dysplasia were assermbced. According to Crowe class analy- sis of hip subluxation or dislocation. 7hips were of type 1 2 of type of type 3 and 30f type 4. In addition to the standard total hip re- placement of the hip, center of the hip acetabular reconstruction included structure attoallergic bone graft and ingression of revlu- tion. Radiography and Harris hip socing were used to evalute the hip function preoperatively and at the follow-up. Results Mean follow-up period was 6.3years（ rang e. P menths to l0 years）. All the patients had restoration of the normal level of rotation center of the hip. Radiograhy showed that al 1 the grafts united to the host bone and no bone adsooption appeared. No prosth loose. The mean Harris score increased from 45.6 preoperatively to 91.3 at the time of last follow-up（ all the patients were satisfied with re- lieved joint pain and joint movement）. Conclusion Structural bone grafts of femoral head or ilium and total hip replacement of the center of revolution of ingression ale effective Ways in the treatment of DDH.