人工全髋关节置换术治疗56例强直性脊柱炎的临床研究

目的]探讨人工全髋关节置换术治疗强直性脊柱炎的疗效。方法]对56例（98髋）强直性脊柱炎患者行人工全髋关节置换术，其中42例（76髋）进行了平均5．6（2．5～10．5）a的随访。结果]至末次随访时，Harris评分由术前的平均26．8（4～51）分提高到了术后的平均85．2（55～94）分，优良率为89．5％。1例感染行Ⅱ期翻修；2例在扩髓时出现股骨颈或股骨距裂缝骨折，但未到达小粗隆以下，未予特殊处置；1例出现足下垂，术后3个月后恢复，1例深静脉血栓，余病例无假体松动、断裂以及脱位发生。异位骨化发生率9．2％（7髋），但对功能无明显影响。结论]人工全髋关节置换术治疗强直性脊柱炎可以明显缓解髋关节疼痛，恢复关节功能，与其它病因的全髋关节置换术相比，并无较高的危险因素。

Clinical study of total hip arthroplasty in treating 56 cases with ankylosing spondylitis

Objective]To probe the efficacy of total hip arthroplasty(THA)in the treatment of patients with ankylosing spondilitis(AS).Method]Ninety-eight THA were performed in 56 patients who had AS,and 42 patients(76 hips)were analyzed retrospectively with an average follow-up period of 5.6 years(ranged,2.5 to 5.5 years).The clinical results were evaluated by the Harris hip scoring system and radiographic analysis.Result]For the latest follow-up,the average Harris hip score improved from 26.8 points(ranged,4 to 51 points)preoperatively to 85.2 points(ranged,55 to 94 points)at the final postoperatively evaluation.89.5% of the patients had an excellent or good results evaluated by Harris hip scoring system postoperatively.One patient was revised for infection,fissured fracture of neck of femur or calcar femorale above the lesser trochanter happended in two patients,one patient had footdrop and recovered 3 months later,1 patient had deep vein thrombosis.There was no sign of loosening,dislocation or fracture of the prosthesis.According to the system of Brooker,the incidence of heterotopic ossification was 9.2 %(7 hips).Conclusion]THA can greatly relieve the pain of the patients who have AS and reconstruct the function of hip joint.Compared with THA operated for other cause of disease,THA in AS leads to no high risk.