全髋关节置换治疗强直性脊柱炎髋关节强直畸形

目的：探讨强直性脊柱炎合并髋关节强直畸形患者行全髋关节置换术的方法及疗效。方法：对5例（8髋）强直性脊柱炎髋关节强直畸形患者行非骨水泥型全髋关节置换术,采用髋关节外侧切口暴露髋关节,生物型假体固定;采用Harris评分,影像学评定术前及术后髋关节功能。结果：5例患者术后平均随访2年,无血管、神经损伤,无切口感染,假体无脱位、松动,髋关节屈曲畸形矫正,8个髋关节总活动度（屈伸、内收、外展、内旋、外旋等6个方向活动总和）由术前平均57°增加为术后平均172°;术后髋痛消失,膝痛、腰骶痛明显改善,步态恢复正常,生活能自理,髋关节功能明显改善,Harris评分由术前平均33.6分提高到术后平均86.8分。结论：全髋关节置换术可作为治疗强直性脊柱炎合并髋关节强直畸形的有效方法。

Treatment of Ankylosing Spondylitis Caused Hip Ankylosis Deformity with Total Hip Replacement

Objective： To study a treatment method for ankylosing spondylitis（AS） caused hip ankylosis deformity with total hip replacement（THR）,and its therapeutic effect.Methods： Five male patients（aged 18～61,mean 32.4 years） with AS and hip ankylosis deformity accepted non-cemented THR.Their disease courses ranged 2～14 years（mean 4.6 years）,and the flexed deformation ranged 30°～70°（mean 58.6°）.Three of them（5 hip jonts） combined with hip bony ankylosis accepted hip jiont operation that hip jionts were exposed by lateral incision and fixed with biotype prothesis.Hip jiont function were evaluated with Harris scoring system and radiographic analysis before and after the operation.Results： The 5 patients were followed up for about 2 years after operation,and no complication such as nerve or blood vessel injury,dislocation,or deep infection happened.There was no sign of migration or loosening of prothesis either.The serious flexed deformity of involved hips were corrected,and the average total motion range of hip increased from 57°to 172° after the operation.The pain in hips,lowerwaists,and knees disappeared or were relieved obviously.Hip joint function improved markedly,and patients got their gait right and could take care of themselves gradually.The average Harris hip score changed from 33.6 to 86.8 after the operation.Conclusion： Total hip replacement is an effective treatment method to hip ankylosis caused by AS.