全髋关节置换术治疗成人髋关节发育不良

目的探讨全髋关节置换术(THA)治疗成人髋关节发育不良的临床疗效。方法采用THA治疗45例髋关节发育不良患者(50髋)。记录术后感染、髋关节脱位、假体松动、神经损伤情况,末次随访时采用Harris评分评定髋关节功能。结果患者均获得随访,时间2~65(24.1±16.0)个月。术后无感染、髋关节脱位、神经损伤等并发症发生。Harris评分由术前7~77(38.0±15.4)分增加到末次随访68~96(87.2±6.0)分,末次随访与术前比较差异有统计学意义(P<0.05)。末次随访时,所有患者患侧髋关节疼痛症状消失,关节活动功能满意;摄髋关节X线片复查显示关节假体位置、宿主骨对臼杯覆盖良好,假体骨骼界面稳固、无松动。结论THA治疗成人髋关节发育不良疗效满意,术中髋臼处理、真臼重建以及股骨假体的选择与安放是手术成功的关键因素。

Total hip arthroplasty in the treatment of developmental dysplasia of the hip

Objective To investigate the clinical effect of total hip arthroplasty(THA)for treatment of adult developmental dysplasia of the hip(DDH).Methods The 45 patients with DDH(50 hips)were treated with THA.The situation of postoperative infection,hip joint dislocation,prosthesis loosening and nerve injury were observed.At the last follow-up,Harris score was used to assess hip function.Results All patients were followed up for 2~65(24.1±16.0)months.No complications such as infection,dislocation of hip joint,nerve injury were found.The Harris score was increased from 7~77(38.0±15.4)points before surgery to 68~96(87.2±6.0)points at the last follow-up(P<0.05).At the last follow-up,the pain symptoms of the effected hip in all patients were disappeared,the activity of hip was satisfactory;X-ray film showed that the joint prosthesis was in normal position,the host bone covered the acetabular cup well,and the prosthesis bone interface was stable without loosening.Conclusions The curative effect of THA for treatment of DDH is satisfactory.Intraoperative acetabular management,acetabular reconstruction and the selection and placement of femoral prosthesis are the key factors for successful operation.