全髋关节置换治疗成人髋关节发育不良继发骨关节炎

目的探讨全髋关节置换治疗成人髋关节发育不良继发骨关节炎的手术方法。方法 2004年1月至2009年7月,对26例（26髋）髋关节发育不良继发骨关节炎患者行全髋关节置换术。其中女25例,男1例,平均年龄48.7岁。按Crowe分型：Ⅰ型8例,Ⅱ型13例,Ⅲ型3例,Ⅳ型2例。采用Harris评分和X线检查评价疗效。结果随访6～72个月,平均36个月。Harris评分：术前平均49.6分（28～65分）,术后平均87.4分（72～92分）。术后无坐骨神经麻痹、下肢深静脉栓塞、切口感染和人工关节脱位等并发症,X线显示假体位置良好,所有病例髋臼均为真臼重建,未见无菌性松动和假体下沉等征象。结论全髋关节置换是治疗髋关节发育不良继发骨关节炎的有效方法。

Total hip arthroplasty for adult developmental dysplasia of the hip associated with osteoarthritis

Objective To study the total hip arthroplasty （THA） for adult developmental dysplasia of the hip （DDH） associated with osteoarthritis.Methods From January 2004 to July 2009,26 patients （26 hips） were treated by THA.There were 25 females and 1 male with an average age of 48.7 years.According to the Crowe classification,there were typeⅠin 8 hips,typeⅡin 13 hips,type Ⅲ in 3 hips,and type Ⅳ in 2 hips.They were evaluated clinically and by radiographs before the operation and during the fllowing-up period,according to the Harris hip score.Results The average follow-up period was 36 months （range 6~72 months）.The preoperative average Harris hip score was 49.6 （range 28 to 65）,and at the final follow up,the average Harris hip score was 87.4 （range72~92）.There were no complications such as sciatic nerve palsy,deep vein thrombosis,infection of incision and dislocation of artificial joint.The position of the components were radiographic satisfactory,all of the acetabula prosthesis were implanted in the true acetabula,there was no sign of aseptic loosening and subsidence.Conclusion THA is an effective way for adult DDH associated with osteoarthritis.