髋臼加盖技术行全髋关节置换术治疗发育性髋脱位

目的探讨髋臼加盖技术行生物型全髋关节置换术(THA)治疗发育性髋脱位(DDH)的临床疗效。方法采用髋臼加盖技术行生物型THA治疗30例DDH患者(30髋),观察手术前后双下肢长度差异、髋关节旋转中心高度和水平距离、移植骨块与髂骨融合时间,记录术后骨溶解、骨长入、臼杯松动情况,采用Harris髋关节评分(HHS)评价手术疗效。结果患者均获得随访,时间24~60(38.8±16.9)个月。双下肢长度差异由术前11~55(25.3±17.2)mm下降到术后0~12(3.7±3.5)mm(P<0.001),髋关节旋转中心高度由术前35~65(46.1±16.7)mm下降到术后18~30(23.7±5.9)mm(P<0.001),髋关节旋转中心水平距离由术前35~55(42.8±8.9)mm下降到术后18~29(23.3±2.7)mm(P<0.001)。移植骨块与髂骨融合时间5~12(7.7±4.9)个月。HHS由术前39~65(41.8±14.8)分提高到末次随访时84~100(93.5±7.9)分(P<0.001)。至末次随访,无一例出现假体周围骨溶解,假体均获得骨长入固定。结论采用髋臼加盖技术行生物型THA治疗DDH,可获得满意临床疗效。

Acetabular capping technique for total hip arthroplasty in the treatment of development dysplasia of the hip

Objective To investigate the clinical efficacy of acetabular capping technique during biological type total hip arthroplasty(THA)in the treatment of developmental hip dislocation(DDH).Methods Thirty patients(30 hips)with DDH were treated with bio-type THA using acetabular capping technique.The differences of the pre-and post-operative double lower limbs length,the height and horizontal distance of the hip rotation center,the fusion time of the bone graft with ilium,the state of osteolysis and bone ingrowth,and the loosening of the cup were observed,and Harris hip score(HHS)was used to evaluate the operative effect.Results All patients were followed up for 24~60(38.8±16.9)months.The differences of both lower limbs length decreased from 11~55(25.3±17.2)mm before surgery to 0~12(3.7±3.5)mm after surgery(P<0.001);the height of the hip rotation center decreased from 35~65(46.1±16.7)mm preoperatively to 18~30(23.7±5.9)mm postoperatively(P<0.001);the horizontal distance of the hip joint rotation center decreased from 35~55(42.8±8.9)mm before surgery to 18~29(23.3±2.7)mm after surgery(P<0.001).The fusion time of the transplanted bone with ilium was 5~12(7.7±4.9)months.HHS increased from 39~65(41.8±14.8)points before surgery to 84~100(93.5±7.9)points at the last follow-up(P<0.001).At the last follow-up,none of the patients had osteolysis around the prostheses,and the prostheses were all obtained bone ingrowth fixation.Conclusions The acetabular capping technique is used to treat DDH with bio-type THA,satisfactory clinical results can be obtained.