全髋关节置换术治疗髋臼骨折后创伤性关节炎的疗效观察

目的探讨人工全髋关节置换术治疗髋臼骨折后髋关节创伤性骨关节炎的疗效。方法本组共随访髋臼骨折后髋关节创伤性骨关节炎患者32例32髋,男20例,女12例,平均年龄45.3岁。本组患者全部行人工全髋关节置换术治疗。所有假体均采用生物型假体。采用Harris、UCLA评分对患者术前术后的髋关节功能进行评分,拍摄标准双髋正位片对假体状态进行影像学评估。结果本组患者平均随访26个月,Harris评分由术前42.5分增加到术后93.6分,UCLA评分由术前3.2分增加到术后8.1分,改变有统计学差异。影像学评估显示假体位置良好,无假体松动、关节脱位、感染及明显假体周围骨溶解等并发症。结论全髋关节置换是治疗髋臼骨折后创伤性关节炎的有效治疗手段,术中尽量采用生物型假体,近期随访结果令人满意。

Outcome of total hip arthroplasty for traumatic arthritis after acetabular fracture

Objective To study the outcome of the total hip arthroplasty（THA） for the traumatic arthritis after acetabular fracture. Methods 32 hips in 32 patients who had the traumatic arthritis after acetabular fracture were followed up, including 20 males and 12 females, mean age 45.3 years old. All the patients recevied THA. All the implants were bio-prostheses. Harris score and UCLA score were used to evaluate the hip function before and after the surgery; the standard anteropostcrior X-ray was adopted for radiographic evaluation of the hip prosthesis. Results A follow-up of 26 months on average was carried out. The Harris score improved from 42. 5 points to 93.6 points postoperatively, and UCLA score improved from 3.2 points to 8. 1 points postoperatively. The changes had statistically significant differences. The radiographic evaluation showed that the prosthesis was in good position, without loosening, dislocation, infection or periprosthetie osteolysis. Conclusions Total hip replacement is an effective treatment for the traumatic arthritis after acetabular fractures; the biological prosthesis should be used as much as possible. It may provide a satisfactory short-term result.